INSTITUTE FOR AMERICAN VALUES

Transcription

1 A Report Released Internationally by the Commission on Parenthood s Future A New Study of Young Adults Conceived Through Sperm Donation Elizabeth Marquardt, Norval D. Glenn, and Karen Clark, Co-Investigators EST INSTITUTE FOR AMERICAN VALUES 1

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3 Acknowledgements This report is released internationally under the auspices of the Commission on Parenthood s Future, an independent, nonpartisan group of scholars and leaders who have come together to investigate the status of parenthood and make recommendations for the future. The lead co-investigator of this report, Elizabeth Marquardt, is director of the Center for Marriage and Families at the Institute for American Values. The Center s online site for engagement is www. familyscholars.org. The co-investigators would like to thank Jeremy Uecker of the University of Texas at Austin for analysis; Chintan Turakhia at Abt SRBI for his expertise and helpfulness; David Mills for copy editing; and the members of the Commission on Parenthood s Future for their advice. Elizabeth Marquardt would like to thank her colleagues at the Institute for American Values for their extraordinary support of and commitment to this project. The views in this report are attributable to the co-investigators alone. Copyright 2010, Institute for American Values. All rights reserved. No reproduction of the materials contained herein is permitted without the written permission of the Institute for American Values. isbn: Institute for American Values 1841 Broadway, Suite 211 New York, NY Tel: (212) Fax: (212) i

4 About the Commission on Parenthood s Future The Commission on Parenthood s Future is an independent, nonpartisan group of scholars and leaders who have come together to investigate the status of parenthood as a legal, ethical, social, and scientific category in contemporary societies and to make recommendations for the future. Commission members convene scholarly conferences; produce books, reports, and public statements; write for popular and scholarly publications; and engage in public speaking. Its members include the following: David Blankenhorn, Institute for American Values Don Browning, University of Chicago Divinity School (Emeritus) Daniel Cere, McGill University (Canada) Karen Clark, FamilyScholars.org, co-investigator Jean Bethke Elshtain, University of Chicago Divinity School Maggie Gallagher, Institute for Marriage and Public Policy Norval D. Glenn, University of Texas at Austin, co-investigator Robert P. George, Princeton University Amy Laura Hall, Duke University Timothy P. Jackson, Emory University Kathleen Kovner Kline, University of Colorado School of Medicine Suzy Yehl Marta, Rainbows Inc. Elizabeth Marquardt, Institute for American Values, co-investigator Mitchell B. Pearlstein, Center of the American Experiment David Popenoe, Rutgers University (Emeritus) Stephen G. Post, Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University Dave Quist, Institute of Marriage and Family Canada Luis Tellez, Witherspoon Institute David Quinn, Iona Institute (Ireland) Amy Wax, University of Pennsylvania Law School W. Bradford Wilcox, University of Virginia John Witte, Jr., Emory University Peter Wood, National Association of Scholars ii

7 Executive Summary In 1884, a Philadelphia physician put his female patient to sleep and inseminated her with sperm from a man who was not her husband. The patient became pregnant and bore a child she believed was the couple s biological offspring. Today, this event occurs every day around the world with the willing consent of women and with the involvement of millions of physicians, technicians, cryoscientists, and accountants. The United States alone has a fertility industry that brings in $3.3 billion annually. Meanwhile, fertility tourism has taken off as a booming global trade. A number of nations bill themselves as destinations for couples who wish to circumvent stricter laws and greater expense in their own countries in order to become pregnant using reproductive technologies. The largest sperm bank in the world, Cryos, is in Denmark and ships three-quarters of its sperm overseas. In the U.S., an estimated 30,000-60,000 children are born each year through sperm donation, but this number is only an educated guess. Neither the industry nor any other entity in the U.S. is required to report on these vital statistics. Most strikingly, there is almost no reliable evidence, in any nation, about the experience of young adults who were conceived in this way. This study is the first effort to learn about the identity, kinship, wellbeing, and social justice experiences of young adults who were conceived through sperm donation. The survey research firm Abt SRBI of New York City fielded our survey through a web-based panel that includes more than a million households across the United States. Through this method we assembled a representative sample of 485 adults between the ages of 18 and 45 years old who said their mother used a sperm donor to conceive them. We also assembled comparison groups of 562 young adults who were adopted as infants and 563 young adults who were raised by their biological parents. We learned that, on average, young adults conceived through sperm donation are hurting more, are more confused, and feel more isolated from their families. They fare worse than their peers raised by biological parents on important outcomes such as depression, delinquency and substance abuse. Nearly two-thirds agree, My sperm donor is half of who I am. 5

8 Nearly half are disturbed that money was involved in their conception. More than half say that when they see someone who resembles them they wonder if they are related. Almost as many say they have feared being attracted to or having sexual relations with someone to whom they are unknowingly related. Approximately two-thirds affirm the right of donor offspring to know the truth about their origins. And about half of donor offspring have concerns about or serious objections to donor conception itself, even when parents tell their children the truth. The title of this report, My Daddy s Name is Donor, comes from a t-shirt marketed to parents of babies who were donor conceived. The designers of the shirt say it s just meant to be funny. But we wondered how the children feel when they grow up. This unprecedented, large, comparative, and very nearly representative study of young adults conceived through sperm donation responds to that question. The extraordinary findings reported in the stories, tables and figures that follow will be of concern to any policy maker, health professional, civic leader, parent, would-be parent, and young or grown donor conceived person, anywhere in the world. An extensive list of recommendations is found at the conclusion. We aim for nothing less than to launch a national and international debate on the ethics, meaning, and practice of donor conception, starting now. 6

9 Fifteen Major Findings from My Daddy s Name is Donor: A New Study of Young Adults Conceived Through Sperm Donation Elizabeth Marquardt, Norval D. Glenn, and Karen Clark, co-investigators 1. Young adults conceived through sperm donation (or donor offspring ) experience profound struggles with their origins and identities. Sixty-five percent of donor offspring agree, My sperm donor is half of who I am. Forty-five percent agree, The circumstances of my conception bother me. Almost half report that they think about donor conception at least a few times a week or more often. The role of money in their conception disturbs a substantial number of donor offspring. Forty-five percent agree, It bothers me that money was exchanged in order to conceive me. Forty-two percent of donor offspring, compared to 24 percent from adoptive families and 21 percent raised by biological parents, agree, It is wrong for people to provide their sperm or eggs for a fee to others who wish to have children. When they grow up, donor offspring are more likely to agree, I don t feel that anyone really understands me, with 25 percent of them agreeing strongly, compared to 13 percent of the adopted and nine percent of those raised by biological parents. 2. Family relationships for donor offspring are more often characterized by confusion, tension, and loss. More than half (53 percent) agree, I have worried that if I try to get more information about or have a relationship with my sperm donor, my mother and/or the father who raised me would feel angry or hurt. Seventy percent agree, I find myself wondering what my sperm donor s family is like, and 69 percent agree, I sometimes wonder if my sperm donor s parents would want to know me. Nearly half of donor offspring (48 percent) compared to about a fifth of adopted adults (19 percent) agree, When I see friends with their biological fathers and mothers, it makes me feel sad. Similarly, more than half of donor offspring (53 percent, compared to 29 percent of the adopted adults) agree, It hurts when I hear other people talk about their genealogical background. Forty-three percent of donor offspring, compared to 15 percent of adopted persons and six percent of those raised by their biological 7

10 parents, agree, I feel confused about who is a member of my family and who is not. Almost half of donor offspring (47 percent) agree, I worry that my mother might have lied to me about important matters when I was growing up, compared with 27 percent of the adopted and 18 percent raised by their biological parents. Similarly, 43 percent of donor offspring, compared to 22 percent and 15 percent, respectively, of those raised by adoptive or biological parents, agree, I worry that my father might have lied to me about important matters when I was growing up. When they grow up, well over half (57 percent) of donor offspring agree, I feel that I can depend on my friends more than my family about twice as many as those who grew up with their biological parents. 3. Donor offspring often worry about the implications of inter- acting with and possibly forming intimate relationships with unknown, blood-related family members. Well over half of donor offspring 58 percent agree, When I see someone who resembles me I often wonder if we are related, compared to 45 percent of adopted adults and 14 percent raised by their biological parents. Nearly half 46 percent of donor offspring, but just 17 percent of adopted adults and 6 percent of those raised by their biological parents, agree, When I m romantically attracted to someone I have worried that we could be unknowingly related. Similarly, 43 percent of adult donor offspring, and just 16 percent of adopted adults and 9 percent of those raised by their biological parents, agree, I have feared having sexual relations unknowingly with someone I am related to. 4. Donor offspring are more likely to have experienced divorce or multiple family transitions in their families of origin. The married heterosexual parents of the donor offspring are unusually likely to have divorced, with 27 percent of donor offspring reporting that their parents divorced before the respondent was age 16, compared to 14 percent of those who were adopted and 25 percent of those raised by their biological parents. (The comparison between the parents of donor 8

11 offspring and those of the adopted is apt, because in both cases the parents would likely have turned to donor conception or adoption later in their marriages, when marriages on average are more stable.) See Figure 4. (p. 117) Overall, 44 percent of donor offspring experienced one or more family transitions between their birth and age 16, compared to 22 percent of the adopted, and 35 percent of those raised by their biological parents. See Figure 3a. (p. 116) 5. Donor offspring are significantly more likely than those raised by their biological parents to struggle with serious, negative outcomes such as delinquency, substance abuse, and depression, even when controlling for socio-economic and other factors. Donor offspring and those who were adopted are twice as likely as those raised by biological parents to report problems with the law before age 25. Donor offspring are about 1.5 times more likely than those raised by their biological parents to report mental health problems, with the adopted being closer to twice as likely as those raised by biological parents to report the same thing. Donor offspring are more than twice as likely as those raised by biological parents to report substance abuse problems (with the adopted falling between the two groups). See Figure 1. (p. 115) 6. Donor offspring born to heterosexual married couples, single mothers, or lesbian couples share many similarities. In our survey, 262 of the donor offspring report they were born to heterosexual married couples, 113 to single mothers, and 39 to lesbian couples. While at first glance the number of those born to lesbian couples might seem rather small, this study is notable for having even 39 respondents who grew up with this experience. Most studies of the offspring of lesbian or gay parents are based on a smaller or similar number of respondents, and they typically lack the comparison groups that our survey offers. However, we must caution that due to the size of the sample of offspring of lesbian 9

12 Donor of fspring born to single mothers: 7. couples, most reported findings related to that particular group can only suggest differences or similarities, although where significant differences emerge they are noted. All three groups of donor offspring appear fairly similar in a number of their attitudes and experiences. For example, they are all about equally likely to agree that they feel confused about who is a member of their family and who is not, that they fear being attracted to or having sexual relations with someone they are unknowingly related to, that they worry their mother might have lied to them about important matters, and that they have worried about hurting their mother s or others feelings if they tried to seek out their sperm donor biological father. See Table 2. (p. 109) At the same time, there appear to be notable differences between donor offspring born to heterosexual married couples, single mothers, and lesbian couples. Overall, donor conceived persons born to single mothers seem to be somewhat more curious about their absent biological father, and seem to be hurting somewhat more, than those born to couples, whether those couples were heterosexual or lesbian. Donor offspring born to single mothers are more likely than the other two groups to agree, I find myself wondering what my sperm donor s family is like. Most (78 percent) born to single mothers agree, compared to two-thirds of those born to lesbian couples or married heterosexual parents. With regard to My sperm donor is half of who I am, 71 percent of those born to single mothers agree, compared to 46 percent born to lesbian couples and 65 percent born to married heterosexual parents. Regarding family transitions, the single mothers by choice appear to have a higher number of transitions, although if the single mother married or moved in with someone, that would count as at least one transition. Still, with about half (49 percent) of the offspring of single mothers by choice in our sample reporting one or more family transitions between their birth and age 16, it s clear that family change was not uncommon for them. See Figure 3b. (p. 116) 10

13 Donor of fspring born to lesbian couples: 8. Regarding troubling outcomes, even with controls, the offspring of single mothers who used a sperm donor to conceive are almost 2.5 times as likely as those raised by biological parents to report problems with the law before age 25. Similarly, even with controls, the offspring of single mothers who used a sperm donor to conceive are more than 2.5 times as likely as those raise by biological parents to report struggling with substance abuse. See Figure 2. (p. 115) Meanwhile, compared to those born to single mothers or heterosexual couples, those born to lesbian couples seem overall to be somewhat less curious about their absent biological father, and somewhat less likely to report that they are hurting. However, substantial minorities of those born to lesbian couples still do report distressing experiences and outcomes, for example agreeing that the circumstances of their conception bother them, that it makes them sad to see friends with biological fathers and mothers, and that it bothers them that money was exchanged in their conception. Nearly half (46 percent) of the donor offspring born to lesbian couples in our study agree their sperm donor is half of who they are, and more than half (59 percent) say they sometimes wonder if their sperm donor s family would want to know them. Finally, more than one-third of donor offspring born to lesbian couples in our study agree it is wrong deliberately to conceive a fatherless child. See Table 2. (p. 109) Regarding family transitions, the donor conceived born to lesbian mothers appear only slightly less likely to have had one or more family transitions before age 16, compared to the donor conceived born to heterosexual married parents. See Figure 3b. (p. 116) Regarding troubling outcomes, even with controls, the offspring of lesbian couples who used a sperm donor to conceive appear more than twice as likely as those raised by their biological parents to report struggling with substance abuse. See Figure 2. (p. 115) Donor offspring broadly affirm a right to know the truth about their origins. Depending on which question is asked, approximately two-thirds of grown donor offspring support the right of offspring to have non-identifying information about the sperm donor biological father, to know his identity, 11

14 to have the opportunity to form some kind of relationship with him, to know about the existence and number of half-siblings conceived with the same donor, to know the identity of half-siblings conceived with the same donor, and to have the opportunity as children to form some kind of relationship with half-siblings conceived with the same donor. In recent years Britain, Sweden, Norway, the Netherlands, Switzerland, and some parts of Australia, and New Zealand have banned anonymous donation of sperm and eggs. Croatia has recently considered such a law. In Canada, a class-action suit has been launched seeking a similar outcome. This study affirms that a majority of donor offspring support such legal reforms. 9. About half of donor offspring have concerns about or serious objections to donor conception itself, even when parents tell the children the truth about their origins. Of the donor conceived adults we studied, a sizeable portion 44 percent are fairly sanguine about donor conception itself, so long as parents tell their children the truth. But another sizeable portion 36 percent still have concerns about donor conception even if parents tell the truth. And a noticeable minority 11 percent say that donor conception is hard for the kids even if the parents handle it well. Thus about half of donor offspring about 47 percent have concerns about or serious objections to donor conception itself, even when parents tell their children the truth. 10. Openness alone does not appear to resolve the complex risks that are associated with being conceived through sperm donation. In our study, those donor offspring whose parents kept their origins a secret (leaving the donor offspring to find out the truth in an accidental or unplanned way) were substantially more likely to report depression or other mental health issues (51 percent), having struggled with substance abuse (36 percent) or having had problems with the law (29 percent). These differences are very large and striking. See Table 4 (p. 112) Still, while they fared better than those whose parents tried to keep it a secret, those donor offspring who say their parents were always open 12

15 with them about their origins (which are 304 of the donor offspring in our study) still exhibit an elevated risk of negative outcomes. Compared to those raised by their biological parents, the donor offspring whose parents were always open with them are significantly more likely to have struggled with substance abuse issues (18 percent, compared to 11 percent raised by their biological parents) and to report problems with the law (20 percent, compared to 11 percent raised by their biological parents). 11. While a majority of donor offspring support a right to know the truth about their origins, significant majorities also support, at least in the abstract, a strikingly libertarian approach to reproductive technologies in general. Well over half (61 percent) of donor offspring say they favor the practice of donor conception (compared to 39 percent of adopted adults and 38 percent raised by their biological parents). The majority of donor offspring about three-quarters agree, I think every person has a right to a child; Artificial reproductive technologies are good for children because the children are wanted; Our society should encourage people to donate their sperm or eggs to other people who want them; and Health insurance plans and government policies should make it easier for people to have babies with donated sperm or eggs. These numbers are substantially higher than those from adoptive or biological parent families who agree with the same statements. Moreover, in a particularly startling finding, a majority of donor offspring (64 percent) agree, Reproductive cloning should be offered to people who don t have any other way to have a baby, compared to 24 percent who are adopted and 24 percent raised by their biological parents. 12. Adults conceived through sperm donation are far more likely than others to become sperm or egg donors or surrogates themselves. In another startling finding, a full 20 percent of donor offspring in our study said that, as adults, they themselves had already donated their own sperm or eggs or been a surrogate mother. That s compared to 0 percent 13

16 of the adopted adults and just 1 percent of those raised by their biological parents an extraordinary difference. 13. Those donor offspring who do not support the practice of donor conception are more than three times as likely to say they do not feel they can express their views in public. We asked donor offspring whether they favor, oppose, or neither favor nor oppose the practice of donor conception. Of those who favor donor conception, just 14 percent say they do not feel they can express their positive views about donor conception in society at large. By contrast, of those who oppose it, 46 percent said they do not feel they can express these negative views about donor conception in society at large. More than one-third of donor offspring in the study (37 percent), compared to 19 percent of adopted adults and 25 percent raised by their biological parents, agree, If I had a friend who wanted to use a sperm donor to have a baby, I would encourage her not to do it. 14. Donor conception is not just like adoption. Adoption is a good, vital, and positive institution that finds parents for children who need families. There are some similarities between donor conception and adoption, but our study reveals there are also many differences. And, if anything, the similarities between the struggles that adopted people and donor conceived people might share should prompt caution about intentionally denying children the possibility of growing up with their biological father or mother, as happens in donor conception. 15. Today s grown donor offspring present a striking portrait of racial, ethnic, and religious diversity. A full one-fifth 20 percent of the donor offspring in our sample said they are Hispanic, compared to just six percent of those from adoptive families and seven percent of those raised by biological parents. The donor offspring are also well represented among races in general. Many of them grew up with Catholic, Protestant, or Jewish religious identities and/or identify with those traditions today. This striking diversity helps to illustrate the complexity of their experience and the reality of their presence in every facet of American life today. 14

17 Introduction Not so long ago, a couple in the U.S. who was unable to get pregnant and who had reason to think the husband was infertile might appeal to their doctor for help. If their doctor was the sort who made it his business to help such couples, he might know of some medical students at a nearby university willing to donate sperm, or, often enough, he might quietly provide his own. After the insemination, the woman went home instructed to have intercourse with her husband, pretend any resulting baby was entirely theirs, and never speak of that doctor visit again. These days of relying only upon locally produced sperm are long gone. Today, anyone wishing to have a baby and needing sperm, eggs, or a womb has a dizzying array of options. They can include donor eggs, donor sperm, using a traditional or gestational surrogate, embryo donation, or some combination of these. The sperm, eggs, or wombs they procure can come from many different parts of the world. They might still choose a donor or surrogate who happens to live near them. But more often they are likely to go further afield, and sometimes much further afield. Most sperm used in Canada comes from the United States. Most sperm donated in Denmark goes to clinics around the world. Women in nations like Britain, which now restricts the anonymity of donors, often go to Spain, Eastern Europe, or Russia to procure the eggs they need to get pregnant. Would-be parents around the world participate in fertility tourism, going to other nations to get pregnant and secreting their unborn babies back home with no one the wiser about their origins. A clinic in California says it can barely keep up with the demand from patients from France, Spain, Australia, and elsewhere who seek to take advantage of the lax regulations they find in California. 1 Some nations, such as India and South Africa, purposefully market their high quality, low cost fertility services and beautiful beaches to couples from Western nations who are urged to come, relax, receive fertility treatments, and go home pregnant, all for a much lower cost than even one clinic visit back home. India is now the destination of choice for couples seeking a low-cost surrogate mother. Straight and gay couples from the U.S., Canada, Europe, Israel, 15

18 and elsewhere can combine eggs and sperm (their own or someone else s) and have the resulting embryo carried by a village woman in India for a fraction of the cost of, say, an American surrogate, and with no risks of emotional entanglements as a huge added bonus. Today, women in the U.S. shop for sperm donors in online catalogs in much the same way they might shop for a date through a matchmaking service or in much the same way they might buy a piece of furniture or a car. Potential mothers can compare donors heights and weights, ethnic background and physical traits, educational and professional accomplishments, and even view his baby pictures and listen to an audio tape of him expounding on the meaning of life and why sperm donation appealed to him. If it s an egg they need, the same women can show their sometimes reluctant husbands reams of glamour shots of gorgeous young women with improbably impressive educational scores and athletic accomplishments, even assuring their husband, if necessary, that the mystery woman s DNA is preferable to his wife s. Beneath all this pulsing commerce, with dollars and Euros flying around the world, bringing forth babies deposited on doorsteps like the stork of old, for some a major sore point is this: most of it is done in secret. While newly adoptive parents of children from abroad are now strongly counseled to incorporate aspects of their child s home culture into their family life, parents who get their sperm or eggs elsewhere whether from a stranger in the same city or someone halfway around the world quite often do not tell the children that their biological mother or father is anyone other than the parent raising them. A growing proportion of today s babies are global citizens in ways previous generations never dreamed, yet they won t even know the truth unless someone spills the beans. Even the child s pediatrician may not be told the truth as the parents simply, and grossly inaccurately, report their own family medical histories as the child s. Gay and lesbian couples and single persons who use such technologies do tend to be more open with their children and with other important players, including the children s doctors. (For one thing, the obvious absence of either a father or a mother raises the question of where the child came from.) They might also be more likely to acknowledge and 16

19 even celebrate what they know of the child s varied ancestry. But in these families, too, the children are almost never encouraged to acknowledge that the biological father or mother far afield actually is their father or mother. For most gays, lesbians, and singles, and for the relatively small proportion of heterosexual couples who are open with their donor-conceived children, these far away donors are instead the seed providers, or the nice woman who gave me what I needed to have you, or the Y Guy, or any number of other cutesy phrases intended mainly to communicate that despite the fact that one-half of the child s physical being came from this source, this person should nevertheless be of very little importance, if any, to the child. In the U.S. today we have some idea how many children are conceived through egg donation (about 6,000 babies in ), but while the U.S. Centers for Disease Control and Prevention requires clinics to report pregnancies achieved through egg and embryo transfers, it does not require them to report those resulting from sperm donation. Experts estimate that perhaps 30,000 to 60,000 children are conceived in the United States annually through sperm donation, and that currently about one million Americans were conceived this way, but these are little more than educated guesses. The global picture is even more uncertain. The fertility industry is increasingly a cross-border phenomenon. No one knows how many children are being conceived in one country and born in another. In the United States, the first documented case of donor insemination occurred in Philadelphia in the 1880s, when a physician artificially inseminated an unconscious female patient, leaving her to think that her pregnancy was the result of intercourse with her husband. 3 It seems all too appropriate that the first case was veiled in such steep secrecy the truth hidden even from the mother because that is how the practice has been treated for most of its history since. Donor conceived persons typically have not known their status. Their parents were encouraged to keep it a secret from the child, so they only knew the truth when someone their mother or the man they thought was their father, or their grandmother or a family friend spilled the beans, often in the midst of family conflict, or divorce, or after their social father s death. ( Social father is a way of referring to a man who functions as a child s father but is not the biologi- 17

20 cal father.) The small minority who did learn that they had a sperm donor biological father had little if any hope of finding him, since records, if they were kept, were often eventually lost or destroyed. Generations of donor conceived persons have searched, usually in vain, through photographs in the year books of medical schools near the doctor s office where their mother was inseminated, looking for a man who shares their nose or eyes or hair, a man who might be their father. Today, with increasing openness about alternative families and with the power of the internet to bring people together, that secrecy is beginning to lift somewhat. On the one hand, many parents still keep the fact their child is donor conceived a secret from the child. For example, in surveys most women who use donor eggs do not plan to tell their child the truth. (Egg donation itself has only been possible since about 1985.) On the other hand, the types of families now increasingly likely to use donor sperm tend to be at least somewhat more open about it. As treatments for male infertility have improved to the extent that few heterosexual couples will need to use donor sperm, the bulk of the sperm bank business in the U.S. and abroad is increasingly being taken up by single women and lesbian couples, women who generally are not medically infertile but who either do not currently have a suitable partner or do not wish to have sexual relations with a man in order to have a child. Yet there are new tensions today. While single and lesbian women tend to be more open with their children about having used a sperm donor (whether or not they acknowledge him to be the child s biological father), they are also more likely to get the sperm from increasingly far flung locales, from across the country and even around the world. 4 For today s donor conceived children, born in an era of big business sperm banking, flipping forlornly through yearbooks at the medical school next to the hospital where they were born is unlikely to yield much information about who their father is. Many do not realize that, at this point, conceiving a baby with donor sperm is an old-fashioned technology. Donor conception first hit the headlines in the middle of the last century. Producer Barry Stevens, in his films Offspring and Bio-Dad, documents the explosion of popular interest in England in the mid-1950s, when it came to light that certain doctors 18

21 were acquiring sperm, inseminating women, and producing unknown numbers of babies. A flurry of medical journal articles, both pro and con, appeared. The church denounced it. Eerie film footage was produced, showing a few nurses grappling with scores of wriggling infants who looked like they had just come off an assembly line. A popular movie released in 1959, starring American singer Julie London, was titled A Question of Adultery. Two years later, Simon and Schuster published a novel, called Seed of Doubt, which touted itself as the explosive, shocking novel about artificial insemination. 5 Today, artificial insemination has gone mainstream, and yet most people are still as ignorant of its effects and implications as were people fifty years ago. As a society, we barely studied the children and never asked how they fared when they grew up. We never asked what would happen to broader social attitudes about fatherhood and motherhood if donor conception became just another way of making a baby. Today, we re grappling with a decades-old technology that we re only beginning to understand, a technology coming of age in the context of world-sweeping changes in law, medicine, and culture. 6 These changes are increasingly defining parenthood, first and foremost, around adult rights to children. 7 We designed this survey instrument to learn more about the identity, kinship, well-being, and social justice experiences of donor conceived adults. The survey research firm Abt SRBI of New York City fielded our survey through Survey Sampling International (SSI). SSI used a web-based panel that includes more than a million households across the United States. 8 Through this method we were able to assemble a representative sample of 485 adults between the ages of 18 and 45 years old who said they were donor conceived. 9 Through the same method we assembled and surveyed a comparison group of 562 similar-aged persons who were adopted as infants, and a group of 563 people of the same age who were raised by their biological parents. 10 The study is notable for several reasons. The first is the unprecedented, large sample. The second is our ability to compare the experience of donor conceived persons with that of people who were not donor conceived both those who were adopted and those who were raised by their biological parents. What is especially notable, however, is that 19

22 the study employs a representative sample drawn from over one million households. These donor conceived adults were simply among a millionplus American households that had signed up to receive web surveys on, well, anything, and who are mostly targeted by marketers. They were not people who responded to an advertisement about a study or who were found through an activist online message board people who, critics could argue, might have an axe to grind on this topic. Nor were they the young children of parents who agreed to talk about their children, a methodology that has merit but does not really allow donor offspring to speak for themselves. While like all studies our survey method has its limitations 11, and like any single study it is not definitive, it does present for the first time, for the world to see, profound insights into the lives and feelings of donor conceived adults. The title of this report is drawn from a t-shirt and bib marketed for parents to purchase for their sperm donor-conceived children. Around the web, one can find pictures of young children wearing items that read, My Daddy s Name is Donor. The designer has said that 99 percent of adults think it s a riot. 12 We wonder what the children wearing the t-shirt might feel as they grow up. What do today s young people conceived with donor sperm think about their experiences? This report is our attempt to respond, as best as we can, to that question. 20

23 THE DADDY BOX A few months ago, Si mone Braquet, 41, of Sugar Land, Texas, and Tim Gullicksen, 41, of San Francisco, found each other on the Internet. Braquet was searching for the sperm donor who d allowed her to become a single mom 10 years earlier. Gullicksen, an anonymous donor intrigued by his own family tree, was looking for his kids. First there were s and phone calls. Then, in March, Gullicksen flew to Texas to meet Braquet and the child they created: a boy with bluish-green eyes and sandy brown hair named McKay. When Braquet told her son that she had tracked down his donor dad, he lit up, she says, then burst into tears. For years, McKay had kept a Daddy Box under his bed filled with special handmade items a painted rock, an angel ornament with his photo in it. Finally, just weeks before his 10th birthday, he had someone to give it to. I ve always wanted a dad, he says. Newsweek, June Why might a child like McKay make a Daddy Box? If McKay could articulate his feelings, he might say something like this to his donor/dad: I want to share who I am with you, because you are half of me. The majority of donor conceived adults in our survey a full 65 percent agree that My sperm donor is half of who I am. 14 Donor conceived persons articulate this thought over and over. A young woman in Pennsylvania says she wants to meet her donor because she wants to know what half of me is, where half of me comes from. 15 Another in Britain says, I want to meet the donor because I want to know the other half of where I m from. 16 Lindsay Greenawalt in Ohio is seeking any information she can find about her sperm donor. She says, I feel my right to know who I am and where I come from has been taken away from me. 17 Olivia Pratten, a Canadian donor offspring who recently launched a class-action law suit in British Columbia, has said in interviews: I think of myself as a puzzle; the only picture I have ever known is half-complete. 18 She clarifies: I m not looking for a dad. Rather, I have questions about who I am and why I do what I do. 19 Danielle Heath of Australia found out when she was 19 years old that she was donor conceived. She reflected: I felt like there was a piece missing. It would complete me to know who I am like. 20 Tom Ellis of Britain told a reporter how he felt after submitting a cheek swab with his DNA to the UK Donor Link registry: It was a huge decision for me to make because it meant admitting that the stranger who helped bring me into the world and who may never want to meet or know me is important to me. But he is a part of me and without him, I will never feel completely whole. 21 Even mothers who use a sperm donor to get pregnant wonder about this issue. One mother of a nine year old son conceived through donor insemination told US News and World Report, Every time I look at him I can t help but wonder who else he is. 22 Many donor conceived adults worry about the consequences of trying to fulfill these longings. More than half (53 percent) agree that 21

24 I have worried that if I try to get more information about or have a relationship with my sperm donor, my mother and/or the father who raised me would feel angry or hurt. Others express discomfort with their origins. Forty-five percent agree that The circumstances of my conception bother me. When we asked how often they think about donor conception, more than onequarter of those in our survey say they do so at least once or more a day, and almost half say they think about donor conception at least a few times a week or more often. Some donor offspring feel isolated and disturbingly unusual, conceived in a way that is just, well, not normal, and not understood by anyone around them. British donor offspring Christine Whipp tells of finding out, at age 41, after a lifetime of painful emotional tumult and powerful feelings of being rejected by her mother, that her mother had used a sperm donor to get pregnant with her: My ancestral home was a glass sample jar, and my [biological] parents never knew one another in either the personal or the biblical sense. I couldn t name a single person who shared this strange, science-fiction style background, and found myself feeling more alone and completely separate from the rest of the human race than I had ever felt before. 23 When Adam Rose found out the truth about his origins, he says, I felt like a freak, because no one else in my perception had been conceived in that way and it was something that nobody had heard of. It was very shocking. 24 Another donor offspring reports she has long struggled with feelings of shame for being conceived in such an unusual way. Katrina Clark, then barely twenty years old, told her own story in a Washington Post essay. She was born to a single mother who was always open with Katrina about the facts of her conception. She had a close, loving relationship with her mother. Still, as she got older and began to wrestle with identity issues, she looked around at friends who had both their parents. That was when the emptiness came over me. I realized that I am, in a sense, a freak. I really, truly would never have a dad. I finally understood what it meant to be donor-conceived, and I hated it. 25 Lindsay Greenawalt s mother, who had her as a single mom, also informed her about the truth of her origins. At the same time, Lindsay 22

25 recalls, her mother never really raised the subject again or encouraged discussion about it. As a teenager, Lindsay writes, she came to feel that: The worst part of this was that I became very shameful of how I was conceived and wished that I was normal in the sense that I came to be from sex rather than a procedure in a doctor s office. The thought of being conceived from a one night stand was more appealing than being conceived by DI [donor insemination]. My mother never met my father, never talked to him, let alone shared an intimate relationship of any kind with him! This lack of contact is simply unnatural. Even though I had never been really told anything about DI or that there are many other children born of this each year, I acquired these beliefs early on. I also unfortunately thought of myself as a freak of nature until I was 18 years old. 26 Twenty-three-year old Alana 27 reports what happened the first time she tried to confide in a friend: In junior high I told my best friend about my conception, she said. Then we had a fight. She told the entire school that I was a test tube baby, essentially a freak of science. She adds, I would like more Donor Kid stories to be publicized and shared without the freak connotation. We asked donor conceived persons the questions At age 15, what feelings best describe how you felt about being donor conceived? and At the age you are now, how do you feel about being a donor conceived person? (The first question was asked only of those who knew at age 15 that they were donor conceived.) Each question offered a list of positive, negative, and neutral terms; respondents could select as many as they wished. At age 15, ten percent chose the powerfully negative term freak of nature and 13 percent chose the equally disturbing phrase lab experiment. The fact that money was involved in their conception seems especially to disturb some donor offspring. In our survey, 45 percent agree that It bothers me that money was exchanged in order to conceive me. Christine Whipp writes: My existence owed almost nothing to the serendipitous nature of normal human reproduction, where babies are the natural progression of mutually fulfilling adult relationships, but rather represented a verbal contract, a financial transaction and a cold, clinical harnessing of medical technology. 28 She continues, The routine manipulation of human gametes has allowed the very essence of life to 23

26 be exploited, commercialized, demeaned and debased. The previously unseen human embryo is now a collectable, valuable resource. 29 Lindsay Greenawalt concurs: Children are being created without any thought that a human being is involved in this. It is simply a business transaction between our parents, the doctor, and the anonymous donor, with no regard to the child. She goes on: It is not simply a donation that these generous men have taken the time to give. Not only are they being paid for this so-called donation, which seems to me to be an oxymoron in the first place. [T]his is not just any blood donation or organ donation; these men who donate sperm (and women who donate ova) are producing children which will, before they re even conceived, be denied the right to know who they are. Stina, a 29 year old law student in Cologne, Germany, says that she s sometimes reluctant to share the truth about her origins with new acquaintances. She is always a bit afraid that my person will be regarded as stained because of my conception, as my parents had to pay my genetic father, an alien person to them, for creating me. For some donor offspring, their deep discomfort about their origins appears to lie, at least in part, in their feeling of being a product made to suit their parents wishes of being made, not born. Lynne Spencer is a nurse and donor conceived adult who interviewed eight other adult donor offspring for a master s thesis. 30 She writes of finding out, as an adult, that her married parents had conceived her with donor sperm. The profound question with which she struggled was this: If my life is for other people s purposes, and not my own, then what is the purpose of my life? 31 In a later exchange she expanded on this thought: I think one of the most unusual aspects of being a donor offspring is the feeling of being inanimate, or that I didn t exist in part. The whole sense that I don t matter, who I am doesn t matter and needs to be repressed. It s only what I represent that matters that I am someone s child, but I m not a person in my own right. Another participant in Lynne Spencer s study said this: I had always been very scared of dying, because I couldn t really come to terms with my nonexistence in the world. I think part of that was to do with the fact that in some sense I didn t feel like I existed in the world, because I didn t know where half of me originated from. It was almost like that part of me had been seriously denied 24

27 because of the secrecy. Nobody had spoken about it for me. [I] t s almost like I had come into the world by magic. 32 Several years ago, a then-39 year old Japanese woman whose mother used donor insemination to conceive her told a reporter that she struggles with this overwhelming feeling: I feel that I came into this world for the sake of my mother. After she died, I started wondering if I had a reason to exist anymore. 33 Christine Whipp reports that she has long felt that having bought and paid for me my mother view[ed] me more as her personal property [rather] than seeing my existence as a serendipitous piece of good fortune. Some donor offspring, even those who have been told the truth about their origins, nevertheless struggle with wild uncertainties about where they came from. One teenage girl, a 17-year-old daughter of a lesbian couple, wrote to an advice columnist 34 : I am a 17-year-old daughter of a lesbian couple. I don t know my father, his name, heritage, or anything. I can only remember one time the topic of my father really came up in conversation. I was eight years old and I denied any interest in knowing about him. I was worried that my parents would think that I am ungrateful for all that they have done for me or that they would get the misconception that I thought they screwed me up. So my father has never been discussed. As a kid, I figured I was a test tube baby (as if I understood what it meant), but now I have no clue. This induces a swell of paranoia about why is this such a big secret. For a while I was even considering the possibility that my Mom may have been raped. I thought about asking my older siblings who were teenagers when I was born, or asking one of my aunts, but I don t want to drag them into this. Besides, I am not sure if they could or would give me the information I seek. Maybe my family thinks as I do that the silence has been around so long that it is just easier to avoid talking about it. 25

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29 TANGLED WEBS Joanna Rose is a donor conceived adult born in the U.K. and now living in Australia, where she recently completed a Ph.D. dissertation on the ethics, kinship, and identity issues raised by donor conception. She launched and won the High Court case that led to a ban on anonymous sperm and egg donation in Britain. Born after her mother conceived her with anonymous donor sperm, she was raised with her mother, social father, and full or half brother (they may have different donor fathers). Joanna learned the truth of her origins when she was about seven or eight years old, after finding her father upset and pressing him to find out what was wrong. She feels that the secret her parents had tried to keep and the fact that her mother had biological connections to both children, while her father did not were huge strains on her parents marriage. Her parents separated when she was about ten years old. For Joanna, one painful irony is that despite her striking success at the national level she still does not know who her own biological father is. She was given a tip that he might be a certain doctor. But after writing to him twice, seeking information on her medical history and ethnic background, and hoping for any sense of closure he might be able to give her, all she has received from him are legal threats and disregard. If he is her father she feels doubly abandoned by him, the first time when he walked away from a child he conceived when he gave away his sperm, and the second time when he rejected her when she was grown. She still would like to know whatever she can about her biological father, whoever he may be. Anything is better, she says, than the paternal oblivion I am left with now. Joanna is a founding member of the group Tangled Webs, which calls itself an action group challenging Donor Conception practices in the U.K., Australia, and internationally. They seek to provide an alterna- 27

30 tive voice to ARTs through greater recognition of the complex, lifelong issues that affect the person created through Donor Conception. Tangled Webs is their term for the intergenerational consequences moral, social, and legal to which donor conception gives rise. When it comes to those intergenerational consequences, our study is revealing. Loss of Biological Father and His Family In our study, the majority of donor conceived adults express longings to know more about their sperm donor biological father and his family. Well over two-thirds of adult donor offspring a full 70 percent agree that I find myself wondering what my sperm donor s family is like. Similarly, 69 percent agree that I sometimes wonder if my sperm donor s parents would want to know me. Donor offspring express significant pain over the loss of their biological father, significantly more even when compared to those who are adopted. In a striking difference, nearly half of the donor offspring (48 percent) compared to about a fifth of adopted adults (19 percent), agree that When I see friends with their biological fathers and mothers, it makes me feel sad. 35 Similarly, more than half of the donor offspring (53 percent, compared to 29 percent of the adopted adults), agree that It hurts when I hear other people talk about their genealogical background. 36 Both groups the donor conceived and the adopted may not know about and did not grow up with one or both biological parents and those parents families, but the donor offspring overall express a great deal more pain, sadness, and confusion about this loss. The theme of looking for my father everywhere is a recurring one among donor offspring. Some have been told a few details about their biological father maybe his height and the color of his hair and eyes. They say these few, shadowy details are often on their minds when they re out in public, walking down the street, riding a bus, scanning a crowd. Could that be him? they ask themselves. In our survey, 58 percent agree that When I see someone who resembles me I often wonder if we are related. (45 percent of adopted adults and 14 percent of those raised by their biological parents agree as well.) 37 The New York Times interviewed two teenage donor offspring who had just discovered that they are half-siblings. One thing the two 28

31 girls quickly realized was that they had both, all their lives, been looking for the same man in a crowd: Danielle and JoEllen realized that they both run through the brief criteria they know about their sperm donor he is 6 feet tall, 163 pounds with blond hair and blue eyes when they see male strangers. It ll always run through my mind whether he meets the criteria to be my dad or not, said JoEllen, of Russel, Pa. She said the same thing happens to her. 38 Donor offspring speak of the anxiety they feel as they scan all those anonymous faces. Narelle Grech of Australia wrote, How would you feel knowing that you could be walking past your own father or any seven of your own [half] brothers or sisters, and not know it? 39 Olivia Pratten of Canada says: I can t help it. It s always on my mind. Do I see him on the bus? Is he my professor? 40 In our survey, one donor conceived adult wrote simply this: Sometimes I wonder if my father is standing right in front of me. Registries For some observers, an answer to the concerns of donor offspring is found in online registries. The same internet technology that fuels a global trade in sperm and eggs is also being employed to try and knit together at least some of the fragments of biological families that are now scattered around the U.S. and the globe. A growing number of web-based registries in the U.S. and other nations can be used by donor conceived offspring, or their parents, to try to locate other half-siblings conceived with the same donor and even, sometimes, to find their sperm donor biological father or egg donor biological mother. But they are voluntary. An offspring is only going to find someone on them if he or she has heard about the same registry and signed up, wishing to be found. It does happen, and half-siblings are found a little more often, but for most donor conceived persons, finding their sperm donor dad is still a very long shot. The most well-known registry in the U.S. is the Donor Sibling Registry, founded by a dynamic leader named Wendy 29

32 Kramer. Kramer used donor insemination to conceive her now-grown son, Ryan, and was first motivated to turn to the internet to try and find his sperm donor father and half-siblings when he expressed a strong desire to know more about where he came from. Before long she had launched a service that has made more than 6,000 matches between half-siblings, or between children and their biological parents. (The number is always rising and will likely be still higher by the time this report appears.) 41 Wendy and Ryan Kramer and the Donor Sibling Registry are routinely featured in the major media and have drawn a lot of sorely-needed attention to the needs of donor conceived children and adults to know where they come from. Kramer is now an active leader in efforts to urge the U.S. sperm and egg bank industry to begin offering an industry-backed registry service. (She wants the registry to be mandatory; the industry wants it to be voluntary.) There are other registries too. A sampling includes the sibling registry service of California, Cryobank, a voluntary program where clients can register the birth of their children and then contact potential siblings. 42 The group Single Mothers By Choice founded a sibling registry after several mothers in our organization coincidentally learned that they had used the same [sperm] donor and that their children were half-siblings. 43 In Britain, UK Donor Link is a pilot program funded by the Department of Health with a mandate to encourage more donors, donor conceived adults and their genetically related half-siblings to register with them and have the chance to make contact with each other. 44 A similar government-run service was started in New Zealand in A donor conceived woman in Germany is seeking to establish a registry there. As demand grows, more registries are likely to appear. But if you are a typical donor conceived person in the U.S. meaning your parents used an anonymous donor it is quite unlikely you will find your biological father through a registry. First, the man chose to be an anonymous donor, not a known donor, which means that at the time he donated he probably did not want to be found. (Although it s true that many sperm donors might not have known about the possibility of being, or would not have had the option to be, a known donor.) There is a chance that the donor s views have evolved since that time and that he s now curious to know about the children that he might have fathered. If so, he has 30

33 to know that registries exist. Then he has to sign up on one. It s helpful if he enters the correct donor number he was given by the clinic when he donated. At the same time, you, the donor offspring, or your mother, have to sign up on the same registry. It s helpful if you or your mother can also enter the correct donor number. It s also helpful if the clinic kept decent records and managed to give the same donor number information both to your mother and the donor. Finally, if a match is made, you have to hope your sperm donor father hasn t already been connected with, say, a dozen or more other offspring and has started to feel overwhelmed by all these DNA tests and emotional s and meetings. Going back to square one, what s far more likely than this scenario is that, instead, the young man who donated sperm when he was in college or medical school, the cash from which he used to pay for groceries that month or buy books for next term, hasn t given much thought to whether children resulted. He finished school, got a job, met someone, married, and had (more) kids. Even if he does speculate with curiosity about those donations from long ago he probably doesn t want to sign up on the internet and risk some kid asking him for money (which is not what donor offspring do, but men fear it anyway), or getting his wife upset, or getting tangled up in the family business of people he doesn t even know. Most likely, if you re a donor offspring hoping to find your biological father on a registry, that distant realm of kinda-curious-but-not-gonna-do-anything-about-it is the land that he inhabits. For most donor conceived children today, and for the vast majority now grown, the Daddy Box they keep under their bed will continue to be filled with mementos and memories they sometimes desperately want to share with a father they will never ever know. Extreme Families Some families have a lot of kids, and some men father children with several different women. For these reasons, people who have been adopted or whose fathers have abandoned their families might well have legitimate concerns that they have full or half siblings, somewhere out there, whom they do not know. But they could still be almost certain that they might have, at the most, perhaps a dozen unknown siblings, but most likely far fewer than that. 31

34 Today, with the advent of big business sperm banking, one man can donate his sperm many times and potentially conceive many, many children. Since a lot of women seem to have a certain type of donor father in mind (tall, blue-eyed, blonde; smart, sensitive, athletic), sperm banks typically have some high demand donors that women choose over and over, eager to make him the biological father of their child. His samples are divided into vials and sold to women all over the country. When wouldbe mothers find to their dismay that his sperm is gone, they sometimes post queries on message boards read by other donor insemination moms, seeking any unused vials that can be bought on the open market. Wendy Kramer reports that on the Donor Sibling Registry at least one sperm donor is confirmed to have more than 100 children, and reports of one donor fathering dozens or even over a hundred offspring are widespread in the U.S. and abroad. All of which means that, today, donor offspring not only grapple with the loss of their biological father and his whole family; that is, with the loss of an entire half of their heritage. They also struggle with the astounding implications of what happens when reproduction is fully disconnected from sex, when social mores that seek, as much as possible, to restrict men to reproducing with one, or at least not more than a few, women are thrown out and anything goes. When young people today discover that they are conceived with a sperm donor, sooner or later they begin to struggle with the dawning awareness that they might well have a half-dozen, or a dozen, or scores, or hundreds, of half-siblings all over the place. Their brothers and sisters might live on the other side of the country or the other side of the world. They might live in the same town. They might live next door. They have no idea. Joanna Rose learned that the British sperm bank from which she was likely conceived had a small number of donors who gave their samples untold numbers of times. The doctor who ran the small clinic later estimated that each man could have between 100 and 300 offspring. 45 Asked how she felt when she found that out, Joanna replied: Dizzy. Just dizzy with just dizzy in so many ways, like [how] could they do that to me, that there could be that lack of thought, that they could be so reckless. 46 Nearly all donor offspring are left with guesswork and back-of-the- 32

35 envelope calculations as they try to figure out how many brothers or sisters they have. At a Canadian conference in 2005, two donor offspring shared their thinking. Shelley Kreutz told the group: We did the math: if half the time a pregnancy results, donating once a week for 5 years, that s the possibility of 235 births, assuming half the time it worked. Olivia Pratten added: It could be less and it could be more, but that s an example. Right now, the system can operate without being accountable to anyone. 47 The result is that donor offspring are left to grieve losses they cannot even fully grasp or imagine. As Narelle Grech put it: I always wanted a brother, and last year I found out I have three! I cried the day I found out, because I was so happy and I also cried because the reality is I may never get to meet or know any of them. It s like they were born and died in my mind all at once. 48 She later learned that she has seven half-siblings. She writes: The clinics and the professor who helped in my creation and mum s treatment deliberately legislated so that I could never know any of them. How is this fair? None of us kids agreed to this anonymity business and if I could meet all seven of them I would. It would mean the world to me. 49 These stories of grief and anger stand in marked contrast to the dominant media presentation of what one mom who used donor insemination calls extreme families. If you ve read anything at all in the newspaper about donor offspring, most likely it was one of a spate of news stories about moms who used the same sperm donor getting their babies, toddlers, and tweens together for picnics at which the kids play, the moms snap lots of pictures, and reporters descend for fascinating human interest stories about today s diverse families. Lots of tumbling toddlers who vaguely resemble one another, smiling broadly for the camera, makes a great story for the newspaper, but it doesn t begin to describe the realities these children face as they grow up. In fact, a not insignificant number of donor offspring are profoundly confused about something the rest of us think is pretty simple: who their families are. In our survey, 43 percent of donor offspring, compared to only 15 percent of adopted persons and just six percent of those raised by their biological parents, agree that I feel confused about who is a member of my family and who is not a nearly three-fold difference 33

36 between the donor conceived and the adopted. 50 At the end of our survey, one respondent commented, I am still having problems putting my real family together. Incest Fea rs a nd Lack of Medical History The concerns of donor offspring do not just lie with purely emotional matters about identity and kinship, as profoundly important as those concerns are. They also have urgent, genuine medical concerns. They fear unknowingly dating one of their half-siblings or they fear their future children unknowingly dating the children of one of their half-siblings. This concern is not at all unreasonable. Some donors have very large numbers of offspring. And would-be mothers from particular subgroups tend to favor certain kinds of donors. For example, if an attractive, well-educated sperm donor also happens to mention in his application that he has a lesbian sister and wants to help lesbian moms, it s likely that lesbian moms will find his profile of interest and consider buying a vial of his sperm. Add that together with the fact that lesbian and gay parents tend to concentrate in lesbian and gay- friendly cities and neighborhoods and, bingo, your lesbian friend at work might well be the mom of your daughter s half-brother. The same social network argument can be made about the independent, alternative-life style embracing women who might opt for being a single mom by choice and who move in circles with other like-minded mothers. Meanwhile, although many sperm banks now serve a national and even global clientele, some can still have strong relationships with surrounding medical centers and the community, and thus significant numbers of children who are similar in age and conceived with the same sperm donor might live in proximity to one another. Message boards are full of these kinds of stories. Recently one single mother by choice discovered that her neighbor, with similar aged children, had used the same sperm donor in other words, that her children s half-siblings literally lived down the block. Their children were toddlers but soon they will be teens who might well find the girl or boy down the street attractive. Donor offspring activist Narelle Grech asks, In the future, will we all have to have a DNA test when we start dating someone, just in case? As if to echo her question, on the Donor Sibling Registry a mom who used a sperm donor and is unable to locate her child s half-siblings 34

37 optimistically concluded that in the future her son, who is currently still a baby, will simply have to have genetic testing with any girl he seriously considers having sex with. In our survey, in the questions that asked about the feelings of donor offspring at age 15 and about currently being a donor offspring, 18 percent of them said that at age 15 they were afraid about not knowing my medical history and 15 percent said that even at that age they were worried about my future children s health or feelings. (At the age they are now, 16 and 15 percent agreed with each of these sentiments.) Also, 46 percent of donor offspring, but only 17 percent of adopted adults and just 6 percent of those raised by their biological parents, agree, When I m romantically attracted to someone I have worried that we could be unknowingly related. 51 Similarly, 43 percent of adult donor offspring, and just 16 percent of adopted adults and 9 percent of those raised by their biological parents, agree, I have feared having sexual relations unknowingly with someone I am related to. 52 A fear that most people raised by their biological parents have never even considered and basically cannot fathom is much on the minds of many donor offspring, far more so even compared to the adopted. Okay, fine, a reader might respond, but has it ever happened that is, has anyone ever accidentally had sex with their brother or sister? Well, yes. Last year in Britain a story came to light of twins, male and female, separated at birth and adopted by different families. They met, fell in love, and married and only then learned they were brother and sister. 53 Having the state say that you have no right to your medical history. Feeling attracted to people you are unknowingly related to. 54 Realizing that you have accidentally committed incest with your half-brother or sister. Watching your own children entering the dating market and, with even more trepidation than the average parent feels, worrying that they might unknowingly date a cousin. These are the worries and fears of adult donor offspring today. And yes, all of it can happen. And, it s only going to get more confusing. One of the most startling findings of our study is this: Among our respondents, a full 20 percent of donor offspring said that, as adults, they themselves had already donated their own sperm or eggs or been a surrogate mother. That s compared to less 35

38 than 0ne percent of the adopted adults in our survey and one percent of those raised by their biological parents an extraordinary difference. 55 The donor offspring are also much more likely than those raised by adopted or biological parents to consider becoming donors. More than half 52 percent of donor offspring, compared to 36 percent of adopted adults and 34 percent raised by their biological parents, said they would consider doing it. 56 What does all this mean? Say you are a donor offspring in 2025, searching for your biological father or mother. If you even find him or her, there s a surprisingly good chance that he or she, too, was a donor offspring. You might have found your biological father or mother, but that parent in turn has no idea where he or she came from. That parent too is missing a biological father or mother and lacking a relationship with or information about that whole side of their family. The fragmented families we see today are getting broken into smaller and smaller pieces. By 2025, the child looking for shards of family history could find only splinters. 36

39 HOW DO DONOR OFFSPRING FARE? Menta l Hea lth, Add iction, and Delinquency In the survey we included three questions that seek to measure social and psychological outcomes for the donor offspring. While these three questions are rather blunt measures, they reveal far more than has ever been known about the mental health and well-being of adult donor offspring and the findings are especially illuminating because we are able to compare them to those who were not donor conceived. Our first question was At any time before age 25, were you ever in trouble with the law? A full 21 percent of donor offspring more than one in five said yes 57, compared to 18 percent of those who were adopted and 11 percent of those raised by biological parents. (please see Table 1) Our next question was Have you ever felt unable to control your use of alcohol or other substances? Again, more than one in five 21 percent of the donor offspring say yes. This compares to 17 percent of adopted adults and 11 percent of those raised by biological parents. And finally we asked, Have you ever been prescribed medication for depression or other mental health problems? In this case, those from adoptive families are the most likely to agree, with 42 percent of them saying they have been prescribed medication for this reason. By comparison, 31 percent of the donor conceived adults say they had, and 28 percent of those raised by their biological parents say the same thing. 58 For a look at these outcomes with significance tests and with controls for age, gender, race, subjective family income at age 16, and mother s education, see the odds ratios in Figure 1 (p. 115). Figure 1 makes clear that the donor conceived and the adopted are both significantly more likely than those raised by their biological parents to struggle with these detrimental outcomes, even when controlling for socio-economic status and other factors. The donor conceived and the adopted are twice as likely as those raised by biological parents to report problems with the law. The donor conceived are more than twice as likely as those raised by biological parents to report substance abuse problems (with the adopted falling between the two groups). And the donor conceived are about 1.5 times as likely as those raised by their biological parents to report mental 37

40 health problems (with the adopted being closer to twice as likely as those raised by biological parents to report the same thing). In the open-ended responses to our survey, some donor offspring offered comments that illustrated some of these findings: I ve never even thought about this before I took this survey, but yes I stay depressed a lot, and would like to know more about my donor s family health. I still have issues with this problem and am seeking professional help. It has helped me to become a stronger person but has scared me emotionally. And: I CUT MY SELF Others shared comments that reflected the sensitivity of this subject for them and their sometimes difficult journeys as they have sought to make sense of it and try to come to a better place: I was uncomfortable with the fact that I was conceived this way at first. But through the support of my family and the positive environment they provided, I turned out fine. This is a very sensitive subject for me, doing this survey felt like therapy! I think everything was covered. I don t feel like it is a big issue for me anymore because I m an adult with a family of my own. It s what you choose to make of it. And one spoke of her recent revelation: I did not know until 3 weeks ago that any of this had happened. I lost a baby in my 6 th month and my mother inadvertently told me of their conception problems. This survey was actually a little spooky. Social Isolation Our study also reveals significant experiences of social isolation among donor offspring. When asked Do you know other people who were conceived with use of a sperm donor? many 54 percent say no. When asked How do you feel talking to non-family members about the fact that you were conceived with a sperm donor? about one-third (34 percent) do say they are very comfortable, but nearly another third (31 percent) say they are only somewhat comfortable. The rest say they are uncomfortable talking to non-family members about their origins or 38

41 don t do it at all. Along with those who are adopted, the donor offspring are more likely to agree, I have experienced many losses in my life with about one-third of donor offspring and the adopted strongly agreeing with this statement, compared to one-fifth of those raised by their biological parents. 59 Overall, it is probably not surprising that so many donor offspring agree that I don t feel that anyone really understands me. Twenty-five percent agree strongly, compared to 13 percent of adopted and nine percent of those raised by biological parents. 60 Some of the responses make it clear that this survey was one of the few if not the only time these young people had been asked questions about their experience. Some donor offspring seemed to find the survey topic painful, and some seemed angry: This survey made me feel sad and I am crying as I am typing this comment. I would like to know other people that have been conceived by a sperm donation and let them know that they re not alone. This is the first time I have had anyone ask me questions of such personal matter, but I am O.K. with it. Yes, I thought this was very personal and it hurt a lot to give the information out. This was a very personal and emotional survey. What could you possibly get from this type [of survey]? Others seemed relieved that someone had shown an interest, and they were eager to learn the results. Wow, I am just blown away with this experience. I am pleased to have been a part of this study. This is a subject that I really do not discuss openly with anyone except very close family or friends. I am thankful for my life and opportunities I have. I do feel that my parents divorce was perhaps my fault. But I had a very strong and supportive mother and grandparents. Thank you for this opportunity. I hope the information gathered in this survey is published in a book or magazine so we can all see what other people like myself have had to go through. Many other donor offspring had brief, positive comments to make about the survey itself, with comments such as very interesting survey, never seen anything else like it, and interested in seeing the results of other people, and I think this was a good topic, and much more. 39

42 Family Instability Until now we have dwelled mainly on the feelings donor offspring have for the family members who are missing from their life their biological father, his family, and their half-siblings. But there is also the matter of the family who are in their life. It appears that using a sperm donor to build a family can markedly increase tensions within that family as well. Lynne Spencer was born in Michigan in She didn t find out the truth about her conception until she was 35 years old, after the man she had always thought was her biological father died. Lynne s parents had a conflictual relationship. When I was in junior high school, she said, my father asked me if I thought that he should divorce my mom. I told him yes. They stayed married, but they were always bickering with each other. Looking back, she thinks the way she was conceived did affect her family. The environment in our house was very emotionally repressive. Some areas were taboo to talk about. My parents would tell sexual jokes with my aunts and uncles, but they did not talk to me about sexuality. The taboo of talking openly about sexuality I know was partly due to the times, when a lot of things weren t talked about openly, but I also believe that it was even more of an uncomfortable topic because of the donor conception and needing to keep that secret. Lynne has spent a lot of time thinking about secrets and how they affect families. Secrets, she says, always affect the interactions and relationships in families, including when donor conception is kept secret. People have to be on guard to make sure they don t accidentally give clues to the secret. Over time, this need to hold back limits the level of emotional intimacy, openness, and honesty between people. Trust was a big issue too. Like many people who find out later in life that they were donor conceived, Lynne feels she always knew something was wrong. She told us: When you grow up and your instincts are telling you one thing and your parents the people you are supposed to be able to trust the most in your life are telling you something else, your whole sense of what is true and not true is all confused. You question your own instincts. You don t know when to believe your own thoughts and feelings, or not. 40

43 Like Lynne, Victoria Reilly, now in her sixties, feels that the decision to use a sperm donor to conceive a child, and the secret her parents kept, caused a great deal of stress in her family. I think that it put a terrible strain on my mother who always tried to be the mediator, she says. I believe that her carrying a child conceived by another man s sperm and raising that child caused [my father] a deep hurt. She doesn t think her father is the only man who might feel this way about donor conception. I think other men whose wives use the DI [donor insemination] method to conceive might also have a hard time dealing with the fact their wives are pregnant by another man, she says. I think it is not good for family dynamics. A history of infertility. Getting pregnant from another man. Keeping an enormous secret from your child and everyone else. Raising a child in which one parent is biologically related to the child and another is not. These experiences and more might account for the strains one hears about when donor conceived adults talk about the families they grew up in. Perhaps not surprisingly, the result can be divorce. Many observers have noted how often donor conceived people who speak out about their stories also tell stories of their parents divorce. In our study the divorce rate for married couples who use donor conception is indeed higher than one would expect. As Figure 4 (p. 117) shows, the married heterosexual parents of the donor conceived persons were unusually likely to have divorced, with 27 percent of them reporting that their parents divorced before the respondent was age 16, compared to 14 percent of those who were adopted and 25 percent of those raised by their biological parents. While the percentage of donor offspring whose parents divorced is not a great deal higher than for those raised, for example, by their biological parents, it is significant for several reasons. Many children raised by their biological parents are conceived before or shortly after their parents marry, while heterosexual married couples do not typically consider other means of having a child whether using reproductive technology or adopting without first trying for some years to conceive a child the old fashioned way. Most divorces occur very early in marriages, so everything else being equal, those raised by their biological parents should be much more likely 41

44 to have experienced parental divorce than those who were conceived with donor sperm, or those who were adopted. Yet the percentage of donor conceived people who experienced their parents divorce appears to be slightly more than that of those raised by their biological parents. And, notably, the percentage of donor offspring whose parents divorced is two times that of those who were adopted. Both groups of parents would likely have turned to donor conception or adoption later in their marriages when marriages, on the whole, are more stable. This pattern that the donor conceived are twice as likely as those who were adopted, and as likely as those raised by their biological parents, to have seen their parents divorce strongly suggests unusual, negative influences on the marriages of those who used a sperm donor to conceive their child. 61 Many donor offspring tell stories of their parents divorce. Some of their stories are quite complex. Andrew is a high school math teacher in Pennsylvania, born in His mother told him when he was about 11 or 12 that his biological father was in fact a sperm donor. That summer he was visiting two cousins and decided to share with them this whopper of a story. He reports, I had only recently learned of my donor-conceived background, and I thought I d impress them with this bombshell. To his horror, though, his cousin merely replied, Oh, I already knew that. Our parents told us about it. Andrew s aunt, uncle, and cousins knew the truth about his origins even when he himself did not. Andrew was shocked and livid. The fact of his donor conception was not the only unsettling factor in Andrew s life. My mother was married at the time of my conception, but he ran off with someone else. My mom divorced him when I was around age one. Then, she remarried when I was six, and her second husband adopted me. He and I never managed to establish any kind of bond, though. He wound up dying very young at age 42 when I was 13. Mom didn t remarry after that. Looking back, he reflected, I d say I never really had a father my whole life even when Dad ( husband #2 ) was alive. Vince lives in Melbourne, Australia. Born in 1980, he found out when he was 21 years old that he was donor conceived. Trying to describe his family, he said, Well my story is a little more complex than most. 42

45 Mum was married in the late 70 s to the man who appears on my birth certificate. Upon trying to start a family they discovered he was infertile, so they saw doctors, specialists, etc., who suggested they try some new revolutionary treatment (IVF), and mum subsequently fell pregnant for the first time. They divorced when he was one or two years old and his mother remarried when he was about three. I grew up believing that her second husband was my father. She changed my surname to his. He reflects, with some astonishment, I had no idea of her first husband until I found out everything at 21 years old. I thought it was just a classic case of being married, divorcing and marrying someone new. But then there was the IVF procedure thrown in the mix. So in reality, Vince says, I have three fathers: 1) The donor who remains a mystery, 2) Mum s first husband who was there when I was born and remains on my birth certificate, and 3) the father who raised me from around three years old, who I know as my dad. Now how, he asks, does all this shape me as a person? At age 29, Vince is trying to figure that out. Our data reflect that the donor conceived experience a particularly high degree of transitions in their family lives as they are growing up. The transitions we asked about included not only divorce but also parental remarriage or formation of a new live-in relationship, a parental remarriage or new live-in relationship ending in divorce or break up, losing touch with a parent, and a parent dying. Again, it s telling to compare the donor conceived born to heterosexual, married parents with those who were adopted by heterosexual, married parents. As Figure 3a (p. 116) reveals, 44 percent of the donor conceived experienced one or more family transitions between their birth and age 16, compared to 22 percent of the adopted. 62 Remarriages have a higher divorce rate than first marriages, and live-in relationships are even more unstable. For the donor conceived, not only are their sperm donor biological fathers generally absent and unknown to them, but a lot more people are likely to be coming into and too often going out of their lives. When they grow up, a high number well over half (57 percent) of donor offspring agree that I feel that I can depend on my friends more than my family which is about twice as many as those who 43

46 grew up with their biological parents (29 percent). 63 Amid a maelstrom of people moving in and out of their lives, the donor offspring too often can feel lost and alone. Within the Sperm Donor Conceived: Of fspring of Heterosex ua l Ma rried Couples, Single Mothers by Choice, a nd Lesbia n Couples For decades, virtually anyone conceived in a clinic with use of donor sperm was born to a woman married to a man at the time of conception. Doctors simply would not have provided the service if she had been unmarried. During the 1970s and 1980s, that picture began to change. Among today s adults who are sperm donor offspring, one can find persons who were born to single mothers and lesbian couples, as well as to heterosexual married couples. In our survey, 262 of the donor conceived report that they were born to heterosexual married couples, 113 to single mothers, and 39 to lesbian couples. While at first glance the number of those born to lesbian couples might seem rather small, our survey is notable for having even 39 respondents who grew up with this experience. Most studies of the offspring of lesbian or gay parents are based on a smaller or similar number of respondents, and they typically lack the comparison groups that our survey offers. 64 Perhaps most striking is how similar all three groups of donor offspring (those conceived to lesbian couples, single mothers, or heterosexual couples) appear to be in their attitudes and experiences. The figures referred to below are found in Table 2. (p. 109) In all three groups, between 40 and 45 percent say, I feel confused about who is a member of my family and who is not. 65 Between 40 and 45 percent say I have feared having sexual relations unknowingly with someone I am related to. Between 40 and 45 percent say When I m romantically attracted to someone I have worried that we could be unknowingly related. Between 40 and 50 say I worry that my mother might have lied to me about important matters when I was growing up. Roughly similar proportions appear to agree I have worried that if I try to get more information about or have a relationship with my sperm donor, my mother and/or the father who raised me would feel angry or hurt. More than half say When I see someone who resembles me I often wonder if we are related. 44

47 More than half say I feel that I can depend on my friends more than my family. More than half say I don t feel that anyone really understands me. But there also appear to be differences. In general, the donor conceived persons born to single mothers seem to be more curious about their absent biological father, and seem to be hurting more, than those born to couples, whether those couples were heterosexual or lesbian. Meanwhile, compared to those born to single mothers or heterosexual couples, those born to lesbian couples seem overall to be somewhat less curious about their absent biological father, and somewhat less likely to report that they are hurting but, at the same time, a substantial minority of those born to lesbian couples do report distressing experiences and outcomes. One caution is that because there are 39 offspring of lesbian couples in our study, for the most part our findings related to that group can only suggest how well or how poorly they are faring. (Other often-cited studies of offspring of lesbian couples are also challenged by similarly small, or even smaller, numbers.) However, in some cases where noted significance tests do reveal significant differences for the offspring of lesbian couples in our study. First, let s look at those born to single mothers by choice. The donor offspring born to single mothers appear more likely than the other two groups to agree that: I find myself wondering what my sperm donor s family is like. Most (78 percent) of those born to single moms said this, compared to two-thirds of those born to lesbian couples or married heterosexual parents. 66 Regarding the statement My sperm donor is half of who I am, a full 71 percent of those born to single moms agree, compared to just under half (46 percent) of those born to lesbian moms and almost two-thirds (65 percent) of those with married heterosexual parents. 67 Next, let s look at those born to lesbian parents. Those who had lesbian moms at birth appear less likely than those who had married heterosexual parents or a single mom at birth to agree with some statements, such as those listed below. Still, it s worth noting that substantial minorities and in one case a majority of those with lesbian moms do appear to agree with the following statements: 68 45

48 One-third (33 percent) of those born to lesbian moms say The circumstances of my conception bother me. One-third (33 percent) say When I see friends with their biological fathers and mothers, it makes me feel sad. More than a third (36 percent) agree It bothers me that money was exchanged in order to conceive me. Well over a third (38 percent) say It hurts when I hear other people talk about their genealogical background. Nearly half (46 percent) say My sperm donor is half of who I am. More than half (59 percent) say I sometimes wonder if my sperm donor s family would want to know me. With regard to family transitions (see Figure 3b, p.116), the donor conceived born to lesbian mothers appear only slightly less likely to have had one or more family transitions before age 16, compared to the donor conceived born to heterosexual married parents. 69 From the same figures, the single mothers by choice appear to have a higher number of transitions, but we have to keep in mind that if the single mother married or moved in with someone, that would count as at least one transition. Still, with about half (49 percent) of the offspring of single mothers by choice in our sample reporting one or more family transitions between their birth and age 16, it s clear that family change was not uncommon for them. How might these feelings and experiences, taken together, affect young people born via donor insemination to lesbian couples or single mothers? As mentioned earlier, we asked three questions about outcomes related to problems with the law, mental health, and substance abuse. Table 3 (p. 111) reports the percentage of respondents who reported each of three conditions, by origin. The table further reports the breakdowns within the donor conceived for those born to married heterosexual parents, lesbian couples, and single mothers. Details on significance tests are available in the table. Also, Figure 2 (p. 115) provides odds ratios with controls for socio-economic status and other factors. The first question was, At any time before age 25, were you ever in trouble with the law? Of those raised by their biological parents, only 11 percent said yes. By contrast, more than twice as many of those who were born to a single mother who used a sperm donor 26 percent said 46

49 yes, and 20 percent of the donor conceived born to married heterosexual parents said the same thing. On this outcome, the donor conceived born to lesbian mothers appear perhaps not that different than those raised by their biological parents. In our sample, 13 percent of those born to lesbian mothers said they had problems with the law growing up. 70 The second question was, Have you ever been prescribed medication for depression or other mental health problems? This time it is the young adults who were adopted who stand out 43 percent of the adopted adults say that they have been prescribed medication for depression or other mental health problems. The donor conceived young people appear only slightly more likely than those raised by their biological parents to say they ve been prescribed medication for these reasons, and the responses for most groups of the donor conceived are statistically, significantly lower than the responses for the adopted. 71 The final question was, Have you ever felt unable to control your use of alcohol or other substances? Just 11 percent of those raised by their biological parents said yes to this question. By contrast, well over twice as many 26 percent of the donor conceived born to a single mother said yes to this question. This time, though, those born to lesbian couples also appear much more likely than those raised by their biological parents to report problems with substance abuse more than one-fifth, or 21 percent. (Meanwhile, the donor conceived born to married heterosexual parents are again more likely than those raised by their biological parents to report this kind of problem, but among the donor conceived they were faring the best on this measure, at 17 percent.) Overall, all three groups of the donor conceived in our study report more substance abuse problems compared to those raised by their biological parents. 72 To summarize this section: Sperm donor conceived persons from all three family structures at birth heterosexual married parents, lesbian couples, or single mothers share many attitudes and experiences in common. But there are differences. For example, compared to others who are donor conceived, the donor conceived born to single mothers seem to be more curious and more distressed about their origins. They are more than twice as likely as those raised by their biological parents to have had problems with the 47

50 law, and more than twice as likely as those raised by their biological parents to have struggled with substance abuse. Meanwhile, those born to lesbian mothers seem to express somewhat less curiosity and less distress about their origins. Still, substantial minorities, and sometimes majorities, of the donor conceived born to lesbian couples in our study do express these troubled feelings, and more than half of them report curiosity about their biological father and his family. Those born to lesbian couples also appear nearly twice as likely as those raised by their biological parents to say they have struggled with substance abuse. Overall, although there are varieties of experiences within the donor conceived, as a group the donor conceived are hurting more, are more confused, feel more isolated from their families, and on some important measures have worse outcomes, than those raised by their biological parents, and no groups of donor offspring appear to be exempted from these possible risks. And some are fine One thing our study makes clear, if it was not clear already, is that donor conceived adults do not speak with one voice. There is diversity of experience and opinion among them, as with any group. Some suffer quite a bit and feel very lost and alone. Some are angry. Many are confused about who is and is not a part of their family. As a group they are significantly more likely than other groups to experience negative outcomes. Most, as we will see, believe strongly in the child s right to know who his or her father is. But there are also donor offspring who say they are not greatly impacted by the whole thing. They re fine. In our survey questions asking how respondents felt at age 15 and currently about being donor conceived, some donor conceived persons said they felt special (28 percent at age 15, 26 percent now); cool (19 percent earlier, 20 percent now); proud (12 percent earlier, 16 percent now); wanted (16 percent earlier, 15 percent now), and a significant minority embrace the more neutral but still basically positive phrasing of not a big deal (37 percent earlier, 43 percent now). From the open-ended question at the end of our survey, here are the unambiguously positive statements that donor offspring wrote: I am proud of being who I am, and grateful for having such a magnificent family. 48

51 Being that I am a donor child I believe that my mom and my dad are my real family. They raised me and cared for me my whole life and I love them more than anything. COMFORTABLE I had a very happy childhood with my two mothers, we continue to have a great relationship. I have no problem being a donor child. I think that even though you were not conceived in a traditional way the love that you receive when you get into the world can make all of the difference in the way you feel about yourself. I think those parents are more imp[ortant] who gave birth to the baby and take care of her rather than donor. I was very comfortable and cool. My moms are both awesome and have done a great job raising us. I m lucky! My life has been good so far! Sperm donating is a great thing. It helps out families. I think having the donor option is great, there are a lot of good people out there who really want kids. We should be cheered when we hear these stories. Whenever anyone from any kind of background says they are doing well, that s good news. But it is also true that their voices do not discount the other voices. Rather than pit those who are fine and those who are suffering against each other, we should ask, rather, are any being harmed at all. Our study strongly suggests there are serious possible harms and risks associated with being conceived with donor sperm. These findings should be of concern to any policy maker, health professional, parent or would-be parent, and social leader in the nations that allow this practice. 49

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53 SECRETS & ANONYMITY It changes your character, when you re always deceiving people. It s dreadful. Ina, who used donor insemination to conceive a child in Britain almost 60 years ago, interviewed in Offspring, a documentary by Barry Stevens Spend a little time talking with donor offspring and the theme of secrecy will arise again and again. At a British conference, donor offspring Lauren Taylor reported, When secrets are kept, the children often grow up sensing something is different within their family. The funny thing is this is not necessarily due to what the parents do say, but as a result of what the parents don t say. 73 American author Lynne Spencer shared at the conference, I cringe from the tension I grew up in because of the shadow of secrecy. My sister and I knew our dad had secrets from us. During my father s illness preceding his death, I wrote in my journal: It feels like he s hiding some secrets from us, like Fort Knox. 74 Another participant said It s only when you introduce secrecy that problems start, big bad problems shame thrives on secrecy. 75 Still another said Secrecy breeds mistrust [it] leads to shame, stigma and discomfort. 76 Many at the conference spoke eloquently and poignantly of how the secrets damaged their relationships with their parents and hurt their families. What I feel sad about is that the secret in our family distanced [my father] from the confidence that he should have felt, that sense of claiming me as his son and really inhabiting the role of father, said film maker Barry Stevens. The secret sits in the family like a little time bomb in the centre of things. 77 Donor offspring Suzanne Ariel reported, They say As long as you love the child enough and want them badly enough, the truth really won t matter. But, we re all here to tell you that the truth does matter. Living as a family with a terrible secret robs the family. It s a terrible, terrible thing to have happen. This rottenness just gets worse over the years. 78 Fort Knox, a time bomb, rottenness, robbing relationships: this is how donor offspring talk about the secrets that too often lie at the heart of their families. Our study makes clear that a legacy of distrust can mark these families. Almost half of donor offspring (47 percent) agree, I worry that my mother might have lied to me about important matters when I was growing up. This compares with 27 percent of those who were adopted and 18 percent raised by their biological parents. 79 Not only are the donor conceived more than two and a half times as likely as those raised by their 51

54 biological parents to agree with this statement, they are about four times as likely to agree strongly. Similarly, 43 percent of donor offspring, compared to 22 percent and 15 percent, respectively, of those raised by adoptive or biological parents, agree that I worry that my father might have lied to me about important matters when I was growing up. 80 Compared to those raised by biological parents, the donor offspring are more than four times as likely to agree strongly. In the open ended responses to our study, one donor offspring said, [I am] currently not on seeing or speaking terms with family because of this. End ing A nony mous Donation? After finding out she was donor conceived, Stina recalls, it felt like: somebody very close to me had died. Every time I remembered the news about my conception, I felt an uttermost pain. I was very disappointed in my parents that they had kept this secret for so long, and that they had actually agreed to an anonymous donation so that I could never find out who the donor is. Donor conception has always been shrouded in secrecy. Anonymity is the thick cloth that permits no one to look inside. For years, the medical profession has touted anonymity as the answer to the quandaries created by sperm and egg donation. Anonymity protects the donor from having to confront the inconvenient truth that a child might be born from his or her own body. It protects parents who do not wish for an outside party to intrude on their family, and who quite often choose not to tell their children. And it certainly facilitates the buying and selling of sperm and eggs as products, no longer identified with one wholly unique human being whose life continues to evolve long after the donation is made. As a director of one of the oldest sperm banks in the U.S. said, [Without anonymity], you re going to lose the really smart, the really wonderful people who I think are going to question, Do I really want to be in a situation where, down the road, someone may contact me? 81 Anonymous donation remains standard practice in the U.S. fertility industry, but changes are percolating, slowly. For some time, at least some professionals involved with donor insemination families have advocated greater openness with the children. The Sperm Bank of California was a pioneer in its early efforts to establish an ID release program, beginning 52

55 in 1983, whereby donor offspring could be given the name of their sperm donor once the offspring turned 18 years old. 82 Other sperm banks are experimenting with offering at least some ID release for known donors, or, at the least, providing a great deal more non-identifying information about the donor than they have provided in the past. There are also growing pressures on the U.S. sperm bank industry to establish a voluntary or mandatory registry service. Yet even though the leading professional organization in the U.S., the American Society for Reproductive Medicine, now recommends that parents who use sperm or egg donors disclose this fact to their children, using an anonymous donor remains the choice of many would-be parents who want to have control over what their child knows, when their child knows it, and who might be involved in their child s life. In the U.S., the balance is greatly tilted toward the rights of donors, parents, and would-be parents. In at least some other nations, the balance is shifting to give more attention to the rights of the offspring. In recent years Britain, Sweden, Norway, the Netherlands, Switzerland, and some parts of Australia and New Zealand have banned anonymous gamete donation. Croatia has become the most recent nation to consider such a law. 83 In Canada, a class-action suit has been launched seeking the same outcome. 84 Advocates make the case in part based on the UN Convention on the Rights of the Child, ratified in 1989 and signed by all member organizations except the U.S. and Somalia, which states that the child shall have the right from birth to a name, the right to acquire a nationality and, as far as possible, the right to know and be cared for by his or her parents. 85 Transcripts of debates at the time make it clear that UN leaders were referring to a child s mother and father. The right to know your parents makes no sense unless these people are understood to be biological parents. 86 In nations that have banned anonymity the regulations vary, but generally the child has the right to request from a sperm or egg bank contact information about his or her biological parent when the child reaches around 15 to 18 years old. In some cases these nations have also established registries to help donor offspring born before the new law was in place to try to find their biological fathers and mothers. In Britain, around the time that anonymity was banned, those 53

56 opposing the ban warned often that ending anonymity would dry up all the sperm in the U.K. Several news articles claimed there was only one sperm donor left in Scotland. 87 Experts raised worries of women turning to the open market for fresh sperm and, briefly, a website did exist that allowed women to obtain fresh, anonymous sperm from men who were willing to circumvent the new law in exchange for cold cash. Even the National Health Service joined in, actively seeking to recruit sperm and egg donors, and trying to entice young men with an inexplicably crass campaign centered around the slogan Give a toss ( toss being a British slang term associated with masturbation). But what really happened? It turns out those worries were for naught. In fact, even with the prospect of their over-18 progeny someday seeking them out, men in Britain are still signing up to be sperm donors, and a few more women are even signing up to be egg donors. (Eggs have long been scarce in Britain, both before and after the ban, which is why British women typically go to Spain, eastern Europe, or Russia for eggs.) Laura Witjens, chair of the National Gamete Donor Trust in the UK, reported in summer 2009 that donor numbers for both sperm and eggs have gone UP since the removal of anonymity, based on the government s own figures (capital letters hers). 88 In the end, though, the question of whether banning anonymity will lead to an increase or a decrease in sperm and egg donations is a secondary one. The primary question is whether it is morally right for the state actively to deny some citizens the knowledge of who their parents are. Several nations have decided the answer is no. Truth Telling No matter where you live, or what the law says you have to do, studies and anecdotal evidence are building a powerful case that if one does use a sperm or egg donor to have a child, telling that child the truth about his or her origins is the right way to go. Parents might resist telling their children the truth for any number of reasons. Perhaps because they want to maintain the public illusion of fertility, or they are afraid the truth will make their child love them less, or they are ashamed and embarrassed and don t know how to bring the topic up. Or perhaps they think their child is too young to understand, or 54

57 they are afraid the donor will wreak havoc on their family s lives or all of these reasons and more. But decades of reports from donor conceived people who learned the truth, somehow, and the stories they tell of how their families were warped and damaged by the secret their parents tried to keep and their massive loss of trust in their parents once they learned the truth all point to the same underlying and timeless principle: Honesty really is the best policy. Even if one could assume that children are better off not knowing, parents cannot guarantee their child will never find out. Someone else in the child s life an aunt, grandparent, or family friend might tell the child. Or the truth will come out in the midst of family conflict or divorce, or after the death of the man the child thought was his or her father. If the social father (that is, the person the offspring understands to be his or her father) develops a serious illness, the parents might feel it is kinder to tell the child that, in fact, the child is probably not at genetic risk for that illness. And it s astonishing how many stories one hears about donor offspring who stumbled upon the truth in a science class or medical school program when, through simple genetic study or testing for a class project, it became clear that at least one of their parents was not, in fact, their biological parent. Studies are now showing that telling a child early and often about his or her donor origins generally appears to produce less negative response in the child. 89 A number of organizations have responded with resources to help in telling. 90 In our study, the donor offspring as a group report a fairly early and high degree of openness among their parents. But our sample of 485 donor offspring only includes people who know their status. If it were somehow possible to sample all adult donor offspring, including the many who do not know or suspect they are donor conceived, by definition we would find many more donor offspring whose parents were not open with them. We put this question to the donor offspring: Parents vary widely in whether and how they tell their children that they were conceived with donor sperm. Thinking carefully, which of the following categories best describes you? These were the responses: My parent(s) were always open with me about how I was conceived: 59 percent My parent(s) kept the fact of my donor conception a secret I only 55

58 learned in an accidental or unplanned way: 20 percent My parent(s) intentionally revealed the facts of my donor conception to me sometime before I was 12 years old: 7 percent My parent(s) intentionally revealed the facts of my donor conception to me sometime after I was 12 years old: 9 percent As we see, well over half (59 percent) of the donor offspring had parents who were always open with them. Another 16 percent had parents who were not open from the child s earliest memories, but who did intentionally tell the child the truth either before (7 percent) or after (9 percent) the child was 12 years old. At the same time, one in five (20 percent) say their parents tried to keep it a secret, leaving their child to find out in an accidental or unplanned way. Because donor offspring often say that finding out when you are a teenager that your father is not your father is exceptionally devastating, we might say that the 9 percent who found out as teenagers, added with the 20 percent whose parents tried unsuccessfully to keep it a secret, form well over a quarter of our sample who discovered the truth in a far less than ideal way. Is Secrecy the Main Problem? Anonymity, secrecy, disclosure, telling, ID release, known donors, registries these are the terms one hears, over and over, in debates about donor conception. In these debates, there is one potential question you re supposed to ignore entirely. That question is this: Is secrecy the main problem with donor conception, or is donor conception itself the main problem? Among experts today, there is considerable and growing support for what we might call the good donor conception narrative. According to this narrative, it s not donor conception that harms children but rather the way that parents handle it. If parents tell their child the truth early and often, they say, the grown children will be fine. Until now, this assumption has not been tested. Let s look again at our data. Although just over a quarter of our group found out about their origins in what we might consider a less than ideal or damaging way, nearly half of the donor offspring in our study (47 percent) agree, I worry that my mother might have lied to me about important matters when I was growing up, and 43 percent say the same thing about their fathers. At least some of the donor offspring 56

59 whose parents were open with them appear nevertheless to have serious trust issues with their mothers and fathers. 91 We asked the donor offspring their opinion on whether secrecy or donor conception itself is the main problem. In the survey, our question was this: Some experts say that donor conception is fine for children so long as parents tell children the truth about their conception from an early age. Other experts say that donor conception can be hard for children, but telling children the truth early on makes it easier for the children. Still other experts say that donor conception is hard for children even if their parents tell them the truth. Do you think These were the responses of the donor offspring: Donor conception is fine for children so long as parents tell children the truth about their conception from an early age: 44 percent Donor conception can be hard for children, but telling children the truth early on makes it easier for the children: 36 percent Donor conception is hard for children even if their parents tell them the truth: 11 percent Of the donor conceived adults we studied, a sizeable portion 44 percent are fairly sanguine about donor conception itself, so long as parents tell their children the truth. But another sizeable portion 36 percent still have concerns about donor conception even if parents tell the truth. And a noticeable minority 11 percent say that donor conception is hard for the kids even if the parents handle it well. Thus almost half of donor offspring about 47 percent have concerns about or serious objections to donor conception itself, even when parents tell their children the truth about their origins. Damian Adams of Australia reports: Even if anonymity was ended it doesn t solve the problems of identity formation, heritage loss and loss of kinship These problems are inherent with the concept of donor conception. Tom Ellis of Britain concurs: The fact that it happens at all [is the problem]. British donor offspring Christine Whipp elaborated: Children should not be treated as commodities for the benefit of the adults who commission them, and they should not be deprived of access to and contact with their biological parents and wider families 57

60 during their formative years. Donor conception cannot be practiced nicely or humanely in a way that does not have any negative impact on the people it creates. It must be the only medical treatment for which somebody other than the patient has to suffer. We looked at our data to learn more. Looking at Table 4 (p. 112), we see that of those donor offspring whose parents kept their origins a secret (leaving the donor offspring finding out in an accidental or unplanned way), a large proportion 51 percent report mental health issues, more than a third 36 percent report having struggled with substance abuse, and 29 percent report having had problems with the law. These differences are significant and striking. Still, while they fared better than those whose parents tried to keep it a secret, those donor offspring who say their parents were always open with them about their origins (which were 304 of the donor offspring in our study) were not spared a higher likelihood of these outcomes. Compared to those raised by their biological parents, the donor conceived whose parents were always open with them are still significantly more likely to have struggled with substance abuse issues (18 percent, compared to 11 percent raised by their biological parents) and to report problems with the law (20 percent, compared to 11 percent raised by their biological parents). These details and more are available in Table 4. (p. 112) Some also suggest that social stigma about donor conception contributes to the suffering of donor offspring. While this might well be true, it is instructive to look at Table 5 (p. 113), which breaks down the donor offspring in our study by age at the time of the survey. If social stigma was a primary source of affliction for donor offspring we might expect that those who were older at the time of the survey would be hurting more. But, on the contrary, the year olds who responded to our survey were more likely to agree with a number of selected statements expressing concern about their experience, while those who were years of age were generally less likely to agree with these statements of concern. This analysis could suggest that the concerns of donor offspring peak in the young adult years, or that for some reason more recent generations of donor offspring are more troubled than earlier ones. Since our study offers a snapshot in time we really have no way of knowing. But, at a minimum, the analysis of the responses of donor offspring by age does 58

61 not support the idea that younger donor offspring, born and raised in an era of increasing openness about donor conception and family diversity in general, are less impacted by donor conception. Overall, our study does not offer much support for the good donor conception narrative. Rather, the findings suggest that if parents have already used, or are intent on using, a sperm donor, then telling their child the truth is definitely the way to go. But openness alone does not appear to resolve the potential losses, confusion, and risks that can come with deliberately conceiving children so that they will be raised lacking at least one of their biological parents. 59

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63 RIGHTS The Ch i ld s Right to Know In our survey, the majority of grown donor offspring expressed firm support for the offspring s right to know everything. When asked if they felt donor conceived persons have the right: To have non-identifying information about their sperm donor: 68 percent of donor conceived, 78 percent of adopted, and 73 percent of those raised by biological parents say yes. To know the identity of the donor: 67 percent of donor conceived, 52 percent of adopted, and 52 percent of those raised by biological parents say yes. To have the opportunity to form some kind of relationship with the donor: 63 percent of donor conceived, 48 percent of adopted, and 47 percent of those raised by biological parents say yes. To know about the existence and number of half-siblings conceived with the same donor: 64 percent of donor conceived, 62 percent of adopted, and 62 percent of those raised by biological parents say yes. To know the identity of half-siblings conceived with the same donor: 62 percent of donor conceived, 54 percent of adopted, and 55 percent of those raised by biological parents say yes. To have the opportunity as children to form some kind of relationship with half-siblings conceived with the same donor: 62 percent of donor conceived, 49 percent of adopted, and 52 percent of those raised by biological parents say yes. Surprisingly, the donor conceived are actually somewhat more cautious than the adopted and those raised by their biological parents when it comes to the question of their right to have non-identifying information about their sperm donor. But when it comes to knowing the identity of their sperm donor and even the possibility of having a relationship with him, the adopted and those raised by biological parents start to fall away, while the donor conceived remain strong in their support for these rights. Moreover, when it comes to the right to know about the existence and number of half-siblings, all three groups broadly support this right, even though those raised by biological parents probably have not given these issues a moment s thought before this survey arrived in their inbox. And 61

64 again, when it comes to the right to know the identity of their half-siblings and to have the possibility as children of having a relationship with them, the support of the adopted and those raised by biological parents weakens, while nearly two-thirds of the donor conceived continue to support these rights as well. It is perhaps surprising that approximately two-thirds of this representative group of donor offspring appear to have no problem supporting the broadest possible assertion of the child s right to know everything. In U.S. law, and in the law of many other nations, donor offspring have absolutely none of these rights. Right now, U.S. federal and state law couldn t care less whether donor offspring know the identity of their biological fathers. In fact, to be more specific, the U.S. federal and state law that does exist is designed explicitly to protect the would-be parents, donors, and fertility clinic doctors who wish to deny the child, at any age, the right to know who his or her father is. If these rights embraced by the majority of donor offspring became law tomorrow, the $3.3 billion U.S. fertility industry would be upended and, at least temporarily, come to a grinding halt. In the open-ended question on our survey, some donor offspring used the space to assert their firm belief in the child s right to know: I definitely think that all sperm and egg donors should be easily accessible and the children should definitely have the choice to find out who they are and be able to contact them. I think it is someone s right to know where and who they come from, to know their identity. I think that children have a right to know ANYTHING in this situation. Also, the sperm donor should be told when they have conceived a child, and asked if they would like a relationship. It is important to know your identity. The Rights of Would-Be Parents But the picture does get more complicated. While the majority of donor offspring firmly support the child s right to know, significant majorities of them also support, at least in the abstract, a strikingly libertarian approach to the practice of donor conception and other reproductive technologies. 62

65 agree. 96 Health insurance plans and government policies should make For starters, well over half of the donor offspring say they favor the practice of donor conception. When asked, What is your opinion of the practice of donor conception? 61 percent say they favor it, compared to 39 percent of adopted adults and 38 percent raised by their biological parents. 92 For their thinking on donor conception and reproductive technologies in general, take a look at their responses to the following four statements: 93 I think every person has a right to a child: 76 percent of donor conceived, 52 percent of adopted, and 54 percent of those raised by biological parents agree. 94 Artificial reproductive technologies are good for children because the children are wanted: 76 percent of donor conceived, 65 percent of adopted, and 61 percent of those raised by biological parents agree. 95 Our society should encourage people to donate their sperm or eggs to other people who want them: 73 percent of donor conceived, 50 percent of adopted, and 42 percent of those raised by biological parents it easier for people to have babies with donated sperm or eggs: 76 percent of donor conceived, 60 percent of adopted, and 54 percent of those raised by biological parents agree. 97 In response to each of these statements, a large majority of the donor conceived adults around three-quarters support strong assertions of the rights of adults to access reproductive technologies, including donor conception, and they support the strengthening of laws and policies to help them do so. If every one of these claims became U.S. law tomorrow, fertility clinic directors around the country would have reason to celebrate. Some donor offspring used the open-ended question at the end of our survey to assert their belief in the rights of adults to access a range of reproductive technologies, including donor conception: Everyone has the right to follow their own paths in life without judgments from others. Everyone out there deserves to have the opportunity to be a parent, even if they have to do it by sperm donation, as long as they don t have a criminal history of crimes against children. 63

66 Everyone should have the right to donors. I think every person has the right to conceive a child and if the person cannot do this naturally they should use all the ways. I think people should be free to do whatever they want to do. I don t condone cloning of human beings. But however a person decides to have a child, it should be a blessing. Very important for Gay and Lesbian families to have equal rights as others. Please be fair to them. I think that donor conception is a wonderful thing and I think every person that really wants to have a baby and believes that she or he wants to be a parent and would be a good parent should have the right to have a baby and sperm donors should be widely accepted in this day and age. As if to underline these attitudes, recall that the donor offspring themselves are far more likely to consider donating their own sperm or eggs or being a surrogate mother, and a great many of them have actually done it. One in five report they have already donated their own sperm or eggs or been a surrogate mother, while almost no one among the adopted or those raised by their biological parents had done so. But before trying to make sense of all this, how about one more surprise? In response to the statement, Reproductive cloning should be offered to people who don t have any other way to have a baby, a majority 64 percent of donor offspring agree, compared to just 24 percent of those who are adopted and 24 percent of those raised by their biological parents. 98 Every nation in the world at least pays lip service to the idea that reproductive cloning is wrong. But a majority of the donor offspring say it s just fine. So What s Up? How can the donor offspring, as a group, embrace both the child s right to know (which happens to be in direct contradiction to current U.S. law) and the would-be parent s right to access a variety of reproductive technologies, anytime, anywhere (which goes well beyond even current U.S. law)? Do the donor offspring want some kind of weirdly-regulated Wild West, in which adults can cook up babies any way they wish so long as the babies get a thick file of information and a chance someday to meet everyone involved? Maybe. But it s also possible that the picture is more complex than it first 64

67 appears. While the donor offspring are quite supportive of donor conception in the abstract and more supportive than their peers who were adopted or raised by their biological parents it appears that the closer the questions get to their own experience, the less they like it. For example, they are more likely to feel repelled by the thought of money being involved in these donated transactions and money is almost always involved. Forty-two percent of donor offspring, compared to 24 percent from adoptive families and 21 percent raised by biological parents, agree that It is wrong for people to provide their sperm or eggs for a fee to others who wish to have children. 99 The deliberate infliction of loss upon the child also concerns the donor offspring. Forty-four percent, compared to 30 percent of adopted adults and 38 percent raised by their biological parents, agree that It is wrong to deliberately conceive a fatherless child. 100 Similarly, 42 percent, compared to 35 and 41 percent, respectively, of those raised by adoptive or biological parents, agree that It is wrong to deliberately conceive a motherless child. 101, 102 Finally, more than one-third of donor offspring (37 percent), compared to 19 percent of adopted adults and 25 percent raised by their biological parents, agree that If I had a friend who wanted to use a sperm donor to have a baby, I would encourage her not to do it. 103 Again, it s only a sizeable minority who would discourage their friend from having a baby the way their mom had them, but it s significantly more than their peers who are not donor conceived. One explanation for this difference is that perhaps we are looking at groups of donor offspring who cluster around two poles. About 60 percent or so of them favor the practice of donor conception and embrace the rights of would-be parents to access it. A good many in this group are likely also among the majority who think, at the same time, that the offspring have a right to know where they come from. At the other pole are about 40 percent of the donor offspring who object to payment for sperm or eggs and who feel it s wrong to create babies who will, before they re even conceived, be denied their father or their mother. A portion of this group are probably among those who oppose the practice of donor conception. If a friend asked their opinion, a good many of them would likely encourage their friend not to have a baby this way. 65

68 Yet, at its root, it might not be as simple as 60 percent of donor offspring are basically okay with the whole thing with the important qualification that the child s right to know be resolved the way they feel it should be -- while 40 percent are troubled by much if not all of it. It is possible that some of the conflicts we see in the donor offspring as a group are also found within at least some donor conceived persons. In other words, some who are suffering those we saw earlier who feel more confusion, more loss, more pain, more isolation, and are more likely to struggle with addiction, delinquency, and depression might also, at the same time, embrace positive attitudes about donor conception. 104 How could this be true? There are several possible explanations. For a donor conceived person, to question donor conception can be to wrestle uncomfortably with the fact of your own existence. Donor conception is why I am here, a donor conceived person might say to him or herself. Some have no trouble reconciling that fact. When an Australian television interviewer tried to challenge activist Myfanwy Walker with the observation that without donor conception she wouldn t be alive implying that her criticisms are therefore meaningless she boldly retorted, Doesn t matter. I am here. 105 But others with misgivings might not have the same clarity. It s also possible that donor conceived people can think of themselves as a small, misunderstood minority. To question or restrict donor conception, some might fear, could lead to discrimination against people like them. And, for those donor offspring who feel isolated and alone, some might think, if there were more like me, hey, maybe I wouldn t feel so lonely. It is also possible that donor offspring who know that they are donor conceived (which is, after all, the only kind of donor offspring we could sample) have been raised with a script that affirms donor conception. What is meant by a script? Recall the resources mentioned in the previous section, which offer tips and talking points for telling your child that he or she is donor-conceived. While it is only relatively recently that a broader consensus has been reached among professionals that parents should voluntarily tell their children the truth about their origins, and many in this 18 to 45 year old age group were growing up when such openness was far from de rigueur, some of the younger adults in our study might 66

69 have had parents who chose to be open and positive in this way. 106 When you have grown up with your mother warmly and frequently telling you that sperm donation is wonderful because it s what allowed her to have you well, such enthusiasm might powerfully shape your own attitude about the practice, despite whatever losses you might have felt. It s also the case that the culture is largely positive about donor conception. Everyone wants to be sensitive to infertile people. Many are sympathetic to single women with ticking biological clocks. A good many also want to embrace and affirm lesbian and gay parents and the choices they make in forming their families. Given the cultural climate, perhaps it s not surprising that one finding of our study is that donor offspring who have reservations about donor conception are far less likely than those who don t have reservations to feel they can express these opinions in public. In our survey, we asked donor offspring whether they favor, oppose, or neither favor nor oppose the practice of donor conception. While 61 percent say they favor it, another 26 percent say they neither favor nor oppose, seven percent say they oppose it, and four percent say don t know. We then asked those who favor and those who oppose whether they feel they can express their views in public. Of those who favor donor conception, just 14 percent say they do not feel they can express their positive views about donor conception in society at large. By contrast, of those who oppose it, 46 percent said they do not feel they can express these negative views about donor conception in society at large. In other words, the donor offspring who oppose donor conception are more than three times as likely to report that they do not feel they can express their views in society at large, compared to those who say they favor it. Is There a Right to a Child? Finally, while our survey turned up a majority of donor offspring who embrace the concept of an adult right to a child, in debates on this topic there are dissenters. Stina says, A child is not a right, but its own person. You do not have a right to a husband or lover either... Damian Adams agrees, There is no right to a child. It is a privilege, and it is unfortunately a privilege not everyone can enjoy. Adam observes, Most women are able to have children. Some aren t. It isn t a right... it just is. 67

70 It is no more of a right than the right to be born with good vision or good health or good looks. We all may want these things, but we don t always get them. Christine Whipp shared this formulation: There is a legal and moral right not to be prevented from indulging in natural procreation, which is framed in various Human Rights conventions. There is no societal right to purloin a child belonging to somebody else, or to expect society to provide a child for somebody who wishes to be a parent. Similarly, Joanna Rose argues that There is the right to try to have a child naturally within your own sexual relationships but not a right to have the genetic child of another [person] outside your sexual relationships, facilitated by artificial means. 68

71 Religion & Race: The Surprising Case of Today s Donor Offspring When you picture an adult whose mother used a sperm donor to conceive him or her, who do you picture? Maybe someone from an alternative, lefty background? Someone raised in an increasingly secular, reproductive technology-embracing era? Someone plain-vanilla white? It s time to expand the picture. Two of the more interesting findings to come to light in this survey are how many of today s adult donor offspring (in our study, people who were 18 to 45 years old in the year 2008) were raised Catholic and are still Catholic today, and how well-represented donor offspring are among all racial and ethnic groups, especially among Hispanics. We asked all survey respondents What religion if any were you raised in? and What is your religious preference today? Thirty-six percent of donor offspring said they were raised Catholic, compared to 22 percent from adoptive families and 28 percent raised by their biological parents. 107 (By contrast, persons from adoptive or biological families and especially those from adoptive families were far more likely to say they had been raised in a Protestant denomination.) This finding is especially striking given that Catholic teaching opposes the use of donor insemination. As adults, donor offspring are also much more likely to say they are Catholic today. About a third of donor offspring 32 percent say Catholicism is their religious preference today. By contrast, their Catholic-raised peers from adoptive families or raised by their biological parents appear more often to have left the Catholic church. 108 As adults, 15 percent of those from adoptive families and 19 percent of those raised by their biological parents say that Catholicism is their religion today. 109 Finally, about a third 32 percent of donor offspring say that they are Protestant today, and nearly one-quarter of all three groups say their religious preference today is none. (Six percent of donor offspring say they are Jewish.) So while a minority of donor offspring do embrace a secular belief system, the majority of them are religious and they are overrepresented in the Catholic church. 69

72 Part of the donor offspring s over-representation in the Catholic church might be due to their ethnicity. Among a series of standard questions inquiring about race and ethnicity, one question was this: Are you, yourself, of Hispanic origin, such as Mexican, Puerto Rican, Cuban, or some other Spanish background? A full one-fifth 20 percent of the donor offspring said they are Hispanic, 110 compared to just six percent of those from adoptive families and seven percent of those raised by biological parents. 111 The donor offspring are also surprisingly well represented among races in general. While 69 percent of them said they are white, another 14 percent said they are black, 13 percent said they are Asian, and three percent said they are other or mixed race. In our study the donor offspring as a group are far more racially diverse than the persons who were adopted or raised by their biological parents. 112 Today s grown donor offspring present a striking portrait of racial, ethnic, and religious diversity one that helps to illustrate the complexity of their experience and the reality of their presence in every facet of American life today. 70

73 Is Donor Conception Just Like Adoption? As we have pursued this study and talked with our colleagues and friends about it, we have often been confronted by this wellmeaning question: Having a baby with a sperm donor isn t that just like adoption? Among those who subscribe to this view are advocates of family diversity who argue that donor conception and adoption are just two among many methods that alternative families use to build their families. 113 The implication is that if society supports adoption, it must support donor conception too. There are some similarities between donor conception and adoption, but there are many more differences. And, if anything, the similarities between adoption and donor conception should prompt caution about intentionally denying children the possibility of growing up with their biological father or mother. When advocates dismiss donor conception as being no big deal, just like adoption, they actually reveal insensitivity to the experience of adopted people. Over decades some adopted people have spoken of the pain of being separated from and not knowing about their biological origins. 114 They recall that when they tried to speak of their struggles they were shamed for not showing enough appreciation to their adoptive parents. In the U.S. and other nations, adoptees have nevertheless managed to secure important legal changes. Keeping children with their natural parents when possible is now a first principle in the family courts. Open adoption is much more common, as is retrospective access to adoption records, although this debate is still very much in play. There is also greater social awareness and acceptance of the needs that at least some adoptees feel to know more about their origins. 115 In talking with adopted people and donor conceived people who yearn to know more about their origins, the deep and virtually identical question they so often seem to share is Why? Why did my biological mother or father give me up? Why did they not want me? Knowing you were wanted by the parents who raised you is undeniably important, but 71

74 this awareness does little to heal the pain of knowing that the parents who made you apparently did not want you. In the case of adoption, at least children can still dream that the birth mother might have struggled with the decision to give up her child. Perhaps the birth mother very much wanted her baby, but because of social or economic circumstances she simply could not raise it, or she was pressured to relinquish it. Or perhaps the birth father would have wanted the child if only he had been informed about the pregnancy. With donor conception, by contrast, the growing child struggles with the dawning realization that his or her biological father or mother sold the goods to make the child without even a look back to say goodbye. Advocates who claim donor conception is no big deal, just like adoption, also reveal their ignorance about fierce controversies in the field of adoption, historically and today. In the recent past, children were too readily separated from birth parents because the state decided that other, richer or more powerful, couples were more suitable to be their parents. Today, there remain serious controversies over open adoption, the rights of adoptees to access their birth records, international and cross-racial adoption, pressures on birth mothers to relinquish children, adoption by gays, lesbians, and singles, and more. Perhaps the most important distinction between donor conception and adoption is this: Adoption is a vital, pro-child institution, a means by which the state rigorously screens and assigns legal parents to already-born (or at least, already conceived) children who urgently need loving, stable homes. In adoption, prospective parents go through a painstaking, systematic review. Some feel the process is so intrusive that it is humiliating. There are home studies. Questions about your finances. Your sex life. Your contacts are interviewed. With every question the possibility hangs in the balance that you might very well not get a child. It is a tough process with one straightforward goal in mind: Protecting the best interests of the child. With donor conception, the state requires absolutely none of that. Individual clinics and doctors can decide what kinds of questions they want to ask clients who show up at their door. They don t conduct home studies. No contacts are interviewed. If you can pay your medical bills, 72

75 they couldn t care less about your finances. Is the relationship in which you plan to raise the child stable? Just say it is, and they believe you. Or do you plan to raise the child alone? Most clinics now say that s fine, too. The end result is the same: A child who is being relinquished by at least one biological parent. But compared to adoption, the process could not be more lax. There are other differences too: Adoption functions as an institution, the purpose of which is to find parents for children who need them. Donor conception functions as a market, the purpose of which is to create children for adults who want them. 116 Adopted children are generally conceived unintentionally. Donor conceived children are conceived very intentionally. Few adoptive parents in the current era would dream of keeping their child s adoption a secret from the child. But parents who use donor conception and especially women who use donor eggs routinely do. Adopted children might wrestle with the sometimes painful knowledge that their biological parents, for whatever reason, could not or would not raise them. At the same time, they know that the parents who adopted them gave them a family and a home. By contrast, donor conceived children know that the parents raising them are also the ones who intentionally denied them a relationship with at least one of their biological parents. The pain they might feel was caused not by some distant birth parent who gave them up, but by the parent who cares for them every day. In our study, donor offspring are very clear about the difference between adoption and donor conception. In response to the statement, It is better to adopt than to use donated sperm or eggs to have a child, nearly half of donor offspring 48 percent agree. 117 Adoptees are even more likely to agree 56 percent of them. And half of those raised by their biological parents also agree 49 percent. 118 In other words, in all three groups, overall about half or more agree that there is a clear difference between adoption and donor conception and that, if would-be parents want a child, they should seek to adopt rather than conceive using donated sperm or eggs. 73

76 In our survey, a number of the donor offspring expanded on this point: I do wish more people would adopt, because there are so many children conceived naturally that need good homes. There are enough people in the world, the world cannot handle any more of humanity s destruction of the world. Think adoption first. Parents who would like to have kids but cannot conceive should adopt because the world is already over populated and there should be equal opportunity to all heterosexual and homosexual parents. There s nothing wrong having two mothers or fathers. DON T DO IT. ADOPT!!! I feel that more should consider the option of adopting, as there are many unwanted children in the world, and seeing one s own genes in a child is not as important as saving a life. Our study also revealed a great many differences between donor conception and adoption. As a group, the donor offspring are suffering more than those who were adopted: hurting more, feeling more confused, and feeling more isolated from their families. (And as a group, the adoptees are suffering more than those raised by their biological parents underscoring the point that we should not separate children from biological parents lightly, but only when necessary for the child s sake.) The donor offspring are more likely than the adopted to have struggled with addiction and delinquency and, like the adopted, a significant number have struggled with depression or other mental illness. Several factors might explain why our study found that adoptees as a whole do better than the donor conceived. While the donor conceived in our study had mothers with the highest level of education in all three groups, the adoptees reported the highest level of family affluence at age 16. The adoptees parents had the lowest rates of divorce of all the groups, while the heterosexual married parents of the donor conceived had the highest rate of divorce. And, while about one-fifth of adults adopted as infants by heterosexual, married parents experienced one or more family transitions before age 16, nearly 40 percent of donor offspring born to heterosexual, married parents experienced this many transitions. (See Figure 3c, p. 117) The greater affluence and family stability of the adoptees 74

77 might explain some of the differences (and the presence of both factors are probably due in part to careful screening by the state, which explicitly sought out the most stable couples to adopt children). But better outcomes for the adopted are likely not just the result of having more money, or even more stable families, even though the latter, especially, is very important for child well-being. It is likely that adoptees also benefit from being raised in this more clear and stable institution known as adoption. An array of laws and social norms surround adoption. People know what it is. Adopted children have a name for it. They have some sense of a structure, and this structure helps them make sense of their experience. In our study, adoptees are far less likely than the donor conceived to say they are confused about who is a member of their family and who is not. They are far less likely to say it is painful to see friends with their biological fathers and mothers. 119 Some adoptees say that adoption itself does not heal the wounds that arise from losing your birth mother and father. But it seems that the care and intent that goes into adoption can at least help. Adoption is a good, positive, and vital institution. But the sometimes painful legacy of adoption, and the extreme seriousness with which the state treats adoption, if anything, underscore that adoption s legality should not justify other practices that intentionally separate children from their biological parents. So, to answer the question so often posed by well-meaning strangers, no, donor conception is not just like adoption. 75

78

79 Recommendations Based on a large, representative, comparative study of adult donor offspring, adoptees, and persons raised by their biological parents, we offer the following recommendations to leaders in the U.S. and around the world. End anonymous donation. Protect the right of ch i ldren to be born from identified, u nta mpered-w ith egg a nd sperm. to leaders in the law: The U.S. should follow the lead of Britain, Sweden, Norway, the Netherlands, Switzerland, and other nations, and end the practice of anonymous donation of sperm and eggs. Registries should be supported that help those born before the law is changed to find their biological kin, when mutually agreeable. In line with Canadian bioethicist Margaret Somerville s recommendation, the right of children to be born from one identified, untamperedwith sperm and one identified, untampered-with egg should be legally affirmed. 120 In fa m i ly law, recognize that the va lue of intentiona l parenthood is actually contested, w ith little empirica l basis thus fa r to support the idea that intentional parenthood is good for children. In family law there is an increasing trend to recognize the legal parent as the person who intended to be the parent. Yet listening to donor offspring reveals that intention is actually a far more problematic term than its proponents in family law suggest. For some donor offspring, the very deliberateness or intention with which they were separated, before their birth, from a biological parent is precisely the problem. Moreover, the one group of young people in our study whose conceptions were 100 percent fully intended that is, the donor offspring is the same group who, on the whole, are reporting more negative outcomes and experiences of loss, hurt, and confusion. Contrary to the arguments put forth by legal scholars who advocate for a guiding principle based on intentional parenthood, there is not much empirical basis to suggest that intentional parenthood is good for children 121, and there are substantial reasons to question that principle. 77

80 To the extent that donor conception occu rs, the state shou ld treat donor conception like adoption. Requ ire cou nseling. Set limits on the nu mber of of fspring born to any one donor. Pediatricians a nd other hea lth professionals must con front the implications of treating ch i ldren conceived through a nony mous donations. Adoption is a child-centered institution that seeks to find parents for children who need them. The state and adoption professionals operate amid a rigorous array of laws and practices, honed over many generations of adoption practice, still admittedly imperfect but designed explicitly to protect the best interest of the child, to keep children with biological kin when possible, and to prevent any practice that suggests a baby market. Donor conception, by contrast, currently operates as a market designed to procure children for adults who want them. There is no state screening of prospective parents. There is no requirement to enact policies that ensure the best interest of the child. The idea that children might need to know and be in contact with their biological kin is treated as a non-issue. Those who support the practice of donor conception often claim it is no big deal because it is just like adoption. If so, then treat it like adoption. to leaders in health policy and practice: Mandatory counseling of donors and parents, and would-be donors and parents, should be in place, and should include a full exploration of what is known about the life course experience of donor offspring. Some nations set this limit at around ten or twelve offspring per donor, which seems far more humane, from the donor offspring s point of view, than the current American Society of Reproductive Medicine recommendation for setting the limit at twenty-five offspring per donor. In the United States it is legal to conceive children using anonymous donor sperm or eggs. At the same time, the genetic, heritable basis of disease is increasingly important in the practice of medicine. What is the position of pediatricians and other health professionals on the practice of anonymous donation, conceiving children who will have dozens or hundreds of unknown half-siblings, parents not telling their children or their children s doctors the truth about the child s biological origins, and sperm and egg banks not being required to track the health of donors and keep parents informed about genetic diseases that donors might develop in the future? These questions can no longer be in the domain solely of fertility doctors. It is time for our nation s pediatricians and other health professionals to confront, wrestle with, and take a firm stand on these issues of urgent importance to a generation of young people. 78

81 For pa rents: Tell the tr uth. For wou ld-be pa rents: Educate you rself f u lly a nd consider not conceiv ing a ch i ld w ith donated sperm or eggs. to parents and would-be parents: Parents who use donor sperm or eggs to conceive absolutely should tell their children the truth about their origins. We fully sympathize with the pain of infertility and the desire to have a child. We also ask that if you are considering having a child with donated sperm or eggs, you avail yourself of all the available information about the impact on children, young people, and their families of being conceived this way. Please consider adoption, or acceptance, or being a loving stepparent, foster parent, aunt or uncle, or community leader who works with children. There are many ways to be actively involved with raising the next generation without resorting to conceiving a child who is purposefully destined never to share a life with at least one of his or her biological parents. Make art from the point of v iew of donor of fspring. Print a nd broadcast med ia must do better stories that include the voices of donor offspring themselves. to leaders in the media and popular culture: In the next year there are at least three Hollywood movies slated for release that star major actresses ( Jennifer Lopez, Jennifer Aniston, and Julianne Moore) in the role of women who have conceived using donor sperm. Writers, directors, and producers should also consider producing films and other narratives that feature the profoundly moving stories of young or grown donor offspring. The U.S. media in particular needs to do a better job of including the voices of donor conceived adults in stories about donor conception. They should no longer simply print heartwarming stories featuring the voices of parents or would-be parents, with some cute donor conceived babies in the background. Those babies become teens and adults who have their own point of view. Seek them out. Tell their stories. Lau nch the gold sta nda rd research projects. to researchers and funders: In the U.S. there is an immediate need for major, large-scale, longitudinal research on the topic of the well-being of donor offspring to be designed, funded, and launched. 79

82 Donor of fspring a re in the pews. W hat do you have to say to them? to religious leaders: Some faith traditions have addressed the complexities of artificial reproductive technologies in the modern world. Most have not. Those religious traditions that reject, ignore, accept, or welcome these practices must grapple with emerging evidence about their impact on children and the broader culture. One intriguing finding from our study is that significant numbers of donor offspring were raised in faith traditions and identify with faith traditions today. They are in the churches and some of them are hurting. What do the churches have to say? Recog n ize that reproductive tech nolog ies create people, not just babies. It s not f u n ny. We must have a n active public debate over whether it is ethical for the state to support the deliberate conception of ch i ldren who w i ll never have the cha nce to be ra ised by their biolog ica l pa rents. to all of us: The offspring created by reproductive technologies grow up to be mature adults and full citizens just like every other person. Their perspective on these technologies is just as important as, and perhaps more important than, the views of doctors, parents, and would-be parents who use these technologies. Some donor conceived people make crass jokes or use black humor as a coping mechanism. That is their right. But just as it is not appropriate for people who are not part of a particular ethnic minority to make jokes about that minority, it is not appropriate for those who are not donor conceived to laugh about donor conception. Jokes about turkey basters, masturbation, and incest are off limits. If in doubt, don t say it. Even if all the above recommendations became realities tomorrow, we would still, as a society, be supporting the practice of conceiving children some number of whom will struggle with significant losses. In no other area of medicine does the treatment have such enormous potential implications for persons who themselves never sought out that treatment (that is, the donor offspring). In ethics, one possible guideline is to ask not Are more harmed than not? but rather Is anyone harmed at all? A significant minority, at least, of donor offspring seriously struggle with losses related to the circumstances of their conception and birth. We must confront the question: Does a good society intentionally create children in this way? 80

83 Elevate donor conceived adu lts as leaders in nationa l a nd internationa l debates about the w ide a rray of tech nolog ies in use, now a nd in the f utu re. Artificial insemination is now an old-fashioned way to make a baby. Egg donation, gestational surrogacy, embryo transfer, and creating babies with the DNA of three parents are already in practice. Babies are now being conceived using the sperm of dead men. A scientist has sought to retrieve eggs from aborted female fetuses for use in research. Reproductive cloning is supported by ten percent of U.S. fertility clinic directors as well as notable, international bioethicists (and by a majority of donor offspring in our study). Scientists in Japan and Australia are working to create offspring with two mothers or two fathers, while scientists in Britain have been granted permission for research purposes to create hybrid embryos which contain both animal and human cells. Our study reveals that, as a group, donor offspring are fairly libertarian in their approach to artificial reproductive technologies in the abstract. But when they tell their own stories, we learn that now-widespread technologies are far more complicated and rife with potentially grave losses for the child than proponents originally thought. No one can predict how the thinking of varied donor offspring will evolve over the decades to come, or what positions the leaders among them will take. At the same time, we cannot deny that those leaders have a rightful and urgently needed role to play as our societies debate how to conceive the next generation of children. 81

84 Table 1: Summary of the Data in percentages I think ever y person has a right to a child. Do you agree or disagree with the following statements? Strongly agree Somewhat agree Somewhat disagree Strongly disagree Donor conceived Adopted Raised by bio Don t know If I had a friend who wa nted to use a sperm donor to have a baby, I wou ld encou rage her not to do it. Strongly agree Somewhat agree Somewhat disagree Strongly disagree Donor conceived Adopted Raised by bio Don t know

88 Parents vary widely in whether a nd how they tell their children that they were conceived w ith donor sperm. Thinking ca ref u lly, wh ich of the follow ing categories best describes you? My parent(s) were always open with me about how I was conceived My parent(s) kept the fact of my donor conception a secret I only learned in an accidental or unplanned way My parent(s) intentionally revealed the facts of my donor conception to me sometime before I was 12 years old My parent(s) intentionally revealed the facts of my donor conception to me after I was 12 years old None of the above 4 Donor conceived Prefer not to answer 1 Of those who lea rned in accidenta l/ u npla n ned way: At what age d id you learn? Donor conceived or younger Over Prefer not to answer 1 86

89 Of those whose pa rents intentiona lly revea led: W hat age were you when you r pa rent(s) told you that you were conceived with the use of a sperm donor? You r best estimate is fine. Donor conceived Older than

95 At the age you a re now, how do you feel about being a donor conceived person? Donor conceived 26 Special Cool 20 Embarrassed 10 Not a big deal 43 Freak of nature 8 Afraid about not knowing my medical history 16 Curious 25 Angry 7 Proud 16 Worried about my current or future children s health or feelings 15 Lab experiment 8 Abandoned 6 Wanted 15 Lonely 6 Confused 9 Depressed <1 Other 2 Prefer not to answer 4 93

96 How of ten do you f ind yourself thinking about donor conception? Donor conceived Several times a day 14 Maybe once each day 13 A few times a week 20 Maybe once a month 13 Maybe every few months 13 Almost never 17 None at all 8 Prefer not to answer 2 Growing up, I sometimes felt like an outsider in my own home. Strongly agree Somewhat agree Somewhat disagree Strongly disagree Donor conceived Adopted Raised by bio Don t know

99 Have you ever donated sperm, eggs, or been a surrogate mother? Donor conceived Adopted Raised by bio Yes 20 <1 1 No Don t Know 2 0 <1 Prefer not to answer 1 <1 <1 Would you consider donating sperm, eggs, or being a su rrogate mother? Donor conceived Adopted Raised by bio Yes No Don t Know Prefer not to answer 2 1 <1 Do you feel donor conceived persons have the right: To have non-identifying information about their sperm donor? Donor conceived Adopted Raised by bio Yes No Don t Know Do you feel donor conceived persons have the right: To k now the identity of the donor? Donor conceived Adopted Raised by bio Yes No Don t Know

100 Do you feel donor conceived persons have the right: To have the opportu n ity to form some kind of relationship with the donor? Donor conceived Adopted Raised by bio Yes No Don t Know Do you feel donor conceived persons have the right: To know about the existence a nd nu mber of ha lf-siblings conceived with the same donor? Donor conceived Adopted Raised by bio Yes No Don t Know Do you feel donor conceived persons have the right: To k now the identity of ha lf-siblings conceived with the same donor? Donor conceived Adopted Raised by bio Yes No Don t Know Do you feel donor conceived persons have the right: To have the opportunity as children to form some k ind of relationship with halfsiblings conceived with the same donor? Donor conceived Adopted Raised by bio Yes No Don t Know

101 Do you want a relationsh ip w ith your sperm donor? Donor conceived Yes 34 No 42 I already have a relationship with my donor 8 Don t Know 12 Prefer not to answer 3 Of those who sa id yes: Do you feel it s okay in society at large for you to say that you wa nt a relationship with your sperm donor? Donor conceived Yes 81 No 13 Don t Know 7 W hat is you r opinion of the practice of donor conception? Donor conceived Adopted Raised by bio Strongly favor Somewhat favor Neither favor or oppose Somewhat oppose Strongly oppose Don t Know Prefer not to answer 2 1 <1 99

102 Of those who favor: Do you feel it s okay for you to say in society at large that you favor the practice of donor conception? Donor conceived Adopted Raised by bio Yes No Don t Know Prefer not to answer Of those who oppose: Do you feel it s okay for you to say in society at la rge that you oppose the practice of donor conception? Donor conceived Adopted Raised by bio Yes No Don t Know Prefer not to answer Some experts say that donor conception is f ine for children so long as pa rents tell ch i ldren the tr uth about their conception from an ea rly age. Other experts say that donor conception ca n be ha rd for ch i ldren, but telling children the truth early on ma kes it easier for the ch i ldren. Sti ll other experts say that donor conception is ha rd for ch i ldren even i f their pa rents tell them the truth. Do you think Donor conception is fine for children so long as parents tell children the truth about their conception from an early age Donor conception can be hard for children, but telling children the truth early on makes it easier for the children Donor conception is hard for children even if their parents tell them the truth Donor conceived Adopted Raised by bio Something else/none of the above Prefer not to answer

103 Do you k now other people who were conceived with use of a sperm donor? Donor conceived Yes 44 No 54 Prefer not to answer 2 How do you feel ta lking to non-fa m i ly members about the fact that you were conceived w ith a sperm donor? Do you feel Donor conceived Very Comfortable 34 Somewhat comfortable 31 Somewhat uncomfortable 18 Very uncomfortable 6 I don t talk to anyone else about it 7 Prefer not to answer 3 Have your feelings about the practice of donor conception changed over time? Donor conceived Yes 35 No 54 Don t Know 9 Prefer not to answer 2 101

104 Have you become: More positive about the practice of donor conception More negative about the practice of donor conception None of the above 4 Donor conceived Prefer not to answer 1 Have you ever been prescribed med ication for depression or other menta l health problems? Donor conceived Adopted Raised by bio Yes No Don t Know 1 < Prefer not to answer Have you ever felt u nable to control you r use of alcohol or other substances? Donor conceived Adopted Raised by bio Yes No Don t Know <1 1 Prefer not to answer At any time before age 25, were you ever in trouble with the law? Donor conceived Adopted Raised by bio Yes No Don t Know <1 1 < Prefer not to answer 102

105 W hat relig ion if a ny were you raised in? Donor conceived Adopted Raised by bio Protestant Catholic Jewish Other None Prefer not to answer W hat is you r relig ious preference today? Donor conceived Adopted Raised by bio Protestant Catholic Jewish Other None Prefer not to answer How relig ious do you currently consider yourself to be? Donor conceived Adopted Raised by bio Very religious Somewhat religious Not very religious Not religious at all Prefer not to answer

106 In genera l, wou ld you say most people ca n be tr usted or you ca n t be too careful in life? Donor conceived Adopted Raised by bio Most people can be trusted You can t be too careful in life None of the above Prefer not to answer I feel that I ca n depend on my friends more than my family. Strongly agree Somewhat agree Somewhat disagree Strongly disagree Donor conceived Adopted Raised by bio Don t Know I have experienced many losses in my life. Strongly agree Somewhat agree Somewhat disagree Strongly disagree Donor conceived Adopted Raised by bio Don t Know

109 Thinking about the time when you were 16 yea rs old, compa red with American families in genera l then, wou ld you say you r fa m i ly income was Donor conceived Adopted Raised by bio Far below average Below average Average Above average Far above average Prefer not to answer W hat is the h ighest level of education your mother completed? Donor conceived Adopted Raised by bio None, or Grade High School Incomplete (Grades 9-11) High School Graduate (Grade 12 or GED certificate) Business, technical, or vocational school after high school Some College, no 4 year degree College Graduate (B.S., B.A., or other 4-Year degree) Post-Graduate training or professional schooling after college Don t Know <

110

111 Table 2: Percentage of Respondents Who Were Sperm Donor Conceived Who Agreed (Strongly or Somewhat) with Selected Statements,by Fa m i ly Structure at Birth The circumstances of my conception bother me. My sperm donor is half of who I am. I find myself wondering what my sperm donor s family is like. I sometimes wonder if my sperm donor s family would want to know me. I have worried that if I try to get more information about or have a relationship with my sperm donor, my mother and/or the father who raised me would feel angry or hurt. It bothers me that money was exchanged in order to conceive me. It hurts when I hear other people talk about their genealogical background. I long to know more about my ethnic or national background. When I see friends with their biological fathers and mothers, it makes me feel sad. Growing up, I sometimes felt like an outsider in my own home. I feel confused about who is a member of my family and who is not. I worry that my mother might have lied to me about important matters when I was growing up. I worry that my father might have lied to me about important matters when I was growing up. When I see someone who resembles me, I often wonder if we are related. When I m romantically attracted to someone I have worried that we could be unknowingly related. I have feared having sexual relations unknowingly with someone I am related to. Lesbian couples (N=39) Married heterosexual parents (N=262) ab b Single mother (N=113) 109

112 I feel that I can depend on my friends more than my family. I have experienced many losses in my life. I don t feel that anyone really understands me. It is wrong for people to provide their sperm or eggs for a fee to others who wish to have children. It is better to adopt than to use donated sperm or eggs to have a child. Our society should encourage people to donate their sperm or eggs to other people who want them. Artificial reproductive technologies are good for children because the children are wanted. If I had a friend who wanted to use a sperm donor to have a baby, I would encourage her not to do it. I think every person has a right to a child. It is wrong to deliberately conceive a fatherless child. It is wrong to deliberately conceive a motherless child. Reproductive cloning should be offered to people who don t have any other way to have a baby. Health insurance plans and government policies should make it easier for people to have babies with donated sperm or eggs. Lesbian couples (N=39) Married heterosexual parents (N=262) b b Single mother (N=113) a Significantly different from married heterosexual parents at p <.05 (two-tailed tests) b Significantly different from single mother at p <.05 (two-tailed tests) 110

113 Table 3: Percentage of Respondents Who Reported Each of Three Conditions, By Origin Donor conceived (N=485) Adopted (N=562) Raised by biological parents (N=563) Among donor conceived Married Lesbian heterosexual Single mothers mother (N=39) parents (N=113) (N=262) Problems with the law 22 a 18 b c 26 ae Mental health problems Substance abuse problems 32 d 43 a d 32 e 22 a 17 b cf 26 ae notes: Ns vary slightly by outcome due to missing data. Percentages are column percentages. a Significantly different from raised by biological parents at p <.001 (two-tailed tests) b Significantly different from raised by biological parents at p <.01 (two-tailed tests) c Significantly different from raised by biological parents at p <.05 (two-tailed tests) d Significantly different from adopted at p <.001 (two-tailed tests) e Significantly different from adopted at p <.05 (two-tailed tests) f Significantly different from donor conceived born to single mother at p <.05 (twotailed tests) (1) Adults who at some point were raised as children by a divorced or single parent can be present in all categories in this table. (2) An average of the responses of the three groups of donor conceived in this table does not equal the numbers reported for mental health, delinquency, and addiction outcomes among the donor conceived generally, because a small number of respondents reported a different type of family structure at birth (e.g., heterosexual unmarried parents) or checked don t know, prefer not to answer, etc. (3) Results for offspring of lesbian couples are not reported as significant due to the sample size (n=39) of those offspring, similar to other studies. (4) Some numbers in first three columns vary slightly from Table 1 due to responses such as don t know and prefer not to answer being included in Table

114 Table 4: Percentage of Respondents Who Reported Each of Three Conditions, By Origin & By How They Fou nd Out About Their Origin Raised by biological parents (N=563) Adopted (N=562) Among donor conceived Parents always open about conception (N=304) Parents kept conception a secret (N=120) Parents revealed conception at age 12 or younger (N=35) Problems with the law b 20 b 29 ae Parents revealed conception at age 13 or older (N=52) Mental health problems a 29 dg 51 a eg Substance abuse problems b 18 bf 36 ad Notes: Ns vary slightly by outcome due to missing data. Percentages are column percentages. a Significantly different from raised by biological parents at p <.001 (two-tailed tests) b Significantly different from raised by biological parents at p <.01 (two-tailed tests) c Significantly different from raised by biological parents at p <.05 (two-tailed tests) d Significantly different from adopted at p <.001 (two-tailed tests) e Significantly different from adopted at p <.05 (two-tailed tests) f Significantly different from donor conceived, parents kept a secret at p <.001 (two-tailed tests) g Significantly different from donor conceived, parents kept a secret at p <.05 (two-tailed tests) 112

115 Table 5: Percentage of Respondents Who Were Sperm Donor Conceived Who Agreed (Strongly or Somewhat) w ith Selected Statements, by Age The circumstances of my conception bother me (N=154) (N=228) My sperm donor is half of who I am I find myself wondering what my sperm donor s family is like. I sometimes wonder if my sperm donor s family would want to know me. I have worried that if I try to get more information about or have a relationship with my sperm donor, my mother and/or the father who raised me would feel angry or hurt. It bothers me that money was exchanged in order to conceive me. It hurts when I hear other people talk about their genealogical background. I long to know more about my ethnic or national background. When I see friends with their biological fathers and mothers, it makes me feel sad. Growing up, I sometimes felt like an outsider in my own home. I feel confused about who is a member of my family and who is not. I worry that my mother might have lied to me about important matters when I was growing up. I worry that my father might have lied to me about important matters when I was growing up. When I see someone who resembles me, I often wonder if we are related. When I m romantically attracted to someone I have worried that we could be unknowingly related. I have feared having sexual relations unknowingly with someone I am related to b b b b b (N=103) 113

116 I feel that I can depend on my friends more than my family. I have experienced many losses in my life. I don t feel that anyone really understands me. It is wrong for people to provide their sperm or eggs for a fee to others who wish to have children. It is better to adopt than to use donated sperm or eggs to have a child. Our society should encourage people to donate their sperm or eggs to other people who want them. Artificial reproductive technologies are good for children because the children are wanted. If I had a friend who wanted to use a sperm donor to have a baby, I would encourage her not to do it. I think every person has a right to a child. It is wrong to deliberately conceive a fatherless child. It is wrong to deliberately conceive a motherless child. Reproductive cloning should be offered to people who don t have any other way to have a baby. Health insurance plans and government policies should make it easier for people to have babies with donated sperm or eggs (N=154) (N=228) b a b (N=103) a Significantly different from at p <.05 (two-tailed tests) b Significantly different from at p <.05 (two-tailed tests) 114

121 Methodology & Limitations Su r vey on Identity, K insh ip, Well-Being and Social Justice Experience of Adu lts Conceived w ith Donor Sperm summary Abt SRBI conducted the Survey on the Identity, Kinship, Well- Being, and Social Justice Experiences of Adults Conceived with Donor Sperm (referred to hereafter as Donor Offspring Survey ). This study was sponsored by the Institute for American Values. Data was collected via web interviews among 1,687 survey panel members. The sample consisted of 562 adults who were or thought they might be conceived through sperm donation, including 485 who knew they were donor offspring; 563 adults who were raised by their biological parents; and 562 adults who were adopted. This study was conducted from July 10 through July 28, Details on the design and execution are provided below. Pilot Study design and data collection procedures Given that sperm donor offspring are rare in the American population, the qualification rate of donor offspring was expected to be very low. In order to develop a sampling methodology and measure study feasibility, Abt SRBI conducted a pilot study. A web survey mode was chosen for this effort due to its ability to screen many households quickly and cost efficiently. The screener interview was made available to 31,020 individuals age from Survey Sampling International s (SSI) SurveySpot Web Panel. Over a period of 2 days, 1,511 screener interviews were completed. Twenty-five, or 1.6%, of the respondents, reported being conceived by a donor. Based on these statistics, the following sampling approach for the main study was developed in consultation with the study co-investigators who held consultations in New York City with social science advisors and others. 119

122 main study design The main study was designed to obtain a total of 1,680 completed surveys among respondents age The respondents would be distributed in three groups: Sperm Donor Conceived Offspring: n=560 Adopted Offspring: n=560 Raised by Biological Parents Offspring: n=560 Abt SRBI assumed the study qualification rate for Sperm Donor offspring at 1.3% and expected to collect surveys from the other two groups in the process of screening for Sperm Donor offspring. contact procedures and screening Respondents from SSI s SurveySpot Web Panel were sent invitations to participate in the survey. After two weeks, non-responders were sent a reminder . A total of 670,524 panel members were sent invitations for this study. The invitations did not say what the survey would be about. A total of 48,637 individuals logged into the survey. Of these, 45,765 were classified as Sperm Donor Offspring, Adopted, or Raised by Biological Parents Offspring. The table below shows the distribution of these groups. Frequency Percent Sperm Donor Offspring % Adopted Offspring % Bio Parents Offspring % Total % System Missing % % Not all respondents who logged into the website completed surveys. Nearly 6 percent dropped out before being classified as one of the target groups. Other mid-survey terminations occurred after the respondent 120

123 classification. Of the 726 respondents who were classified as Sperm Donor offspring, 574 (79%) completed the entire survey and 562 (77%) were considered valid after analyzing para-data: deleted cases included cases with very short survey lengths or evidence of straight-lining (respondents entering the same answer for all questions). Most of the mid-survey terminations were the result of being over quota, as the targets for Adopted and Raised by Biological Parents Offspring had been met. ssi survey spot web panel The web panel utilized for this study was Survey Sampling International s SurveySpot. This panel is built by using 3,400 different sources which employ varied recruitment methods including pop-ups, banners, and text links. Potential respondents are asked to join the panel based upon intrinsic interest in survey participation and sharing of opinions. Panelists are considered active and remain on the panel as long as they remain active (i.e., complete at least one survey every 6 months). Survey Sampling utilizes its 30-plus years of sampling expertise when determining who receives invitations to complete a survey. When selecting the sample for these surveys, a random methodology was employed. limitations In order to recruit a large number of sperm donor offspring for this study, we employed a methodology that is very nearly representative, but not perfectly representative, of year-olds living in the United States in July The survey is representative of Americans who signed up for web-based survey panels, who may differ in unknown ways from Americans as a whole. We believe this bias is unlikely to be substantial. Furthermore, many of our analyses are comparative across types of conception, and it is unlikely that selection into the sample would bias these comparative analyses in any meaningful way. Such a bias would result only if respondents with different origins were systematically more or less likely to select into the sample for different reasons, and we can think of no reason why that would be the case. A second limitation of our sampling strategy is that we were forced to rely on the responses of people who know that they are sperm donor 121

124 offspring. It is unclear whether sperm donor offspring who are ignorant of their origins differ from those who know their origins or from those raised by their biological or adoptive parent(s). Future studies may wish to seek to identify adult offspring of sperm donors through a method that is not contingent on the respondent s knowledge of their origin. However, there are ethical issues with researchers obtaining access to this information about adult study participants and not sharing it with the participants themselves. Lastly, our data are cross-sectional and respondents are often asked to report retrospectively on their experiences, which could be subject to some recall bias. Future studies should attempt to follow donor offspring prospectively through the life course. Nevertheless, the current study is a major contribution to our knowledge of sperm donor offspring. It is the only data of which we are aware that includes large samples of sperm donor conceived, adopted, and biological offspring and focuses on the experiences of the sperm donor conceived. 122

125 Endnotes 1. Chris Ayres, Desperate for a baby? Welcome to a Disneyland for the childless, Times Online, UK, Aug 17, Assisted Reproductive Technology Success Rates: Preliminary Data, National Summary and Fertility Clinic Reports (Atlanta: Centers for Disease Control and Prevention, 2007). An account from the PBS program American Experience reads as follows: 1884: In the first recorded case of artificial insemination by donor, Philadelphia physician William Pancoast treats a couple s infertility by injecting sperm from a medical student into the woman while she is under anesthesia; she gives birth to a boy nine months later. Pancoast never tells the woman what he has done, and only shares the information with her husband several years later. See www. pbs.org/ wgbh/ americanexperience/babies/timeline. Until the last year or so many U.S. women could choose sperm from European sperm banks with the Danish sperm bank, Cryos, being a particularly popular option but an FDA rule enacted several years ago that banned importation of European sperm for fear of transmitting mad cow disease has now impacted options in the U.S., as the final samples of European sperm that were in storage in the U.S. have been used up. See cover at The most well-known studies specifically on donor conception are found in the work of Susan Golombok at Cambridge University and her colleagues. Golombok s papers can be found here: ppsis.cam.ac.uk/cfr/about/people/golombok_papers.php. Her European Study on Assisted Reproduction includes fewer than 100 donor conceived children who she has followed from age 2 into adolescence. At this point, only 8.6 percent have been told the truth about their origins by their parents. Golombok s work sheds light on the experience of these children, but the children are still minors and most of the data is based on interviews with the parents and others and observations of the child, rather than open-ended or extensive interviews with the children themselves. Based on her studies, Golombok is fairly sanguine about the effects of donor insemination on children, but she has not studied a representative sample of adults conceived this way who 123

126 know their status and are speaking for themselves. Golombok is recently partnering with Wendy Kramer of the Donor Sibling Registry to conduct studies of those who congregate at that message board. Another wellknown scholar is Joanna Scheib of the University of California at Davis and the Sperm Bank of California (publications here: thespermbankofca.org/pages/page.php?pageid=9). Most of her work focuses specifically on the fairly small and unusual number of donor conceived offspring who have open-identity donors (a method the Sperm Bank of California pioneered in the 1980s). Among scholars, work by A.J. Turner is also often cited. Alexandra McWhinnie, Patricia Mahlstedt, Lynne Spencer, and Mikki Morrrisette are among others who have not led large studies, but who have framed questions and published writings with the donor offspring s point of view in mind. Donor offspring Bill Cordray has maintained an informal database of survey responses from donor offspring that now number over 100. Work by Charlotte Patterson at the University of Virginia and Judith Stacey of New York University, each of whom study the children of gay and lesbian parents, at times focus on small samples of those conceived through sperm or egg donation or surrogacy. 7. This argument is developed in Elizabeth Marquardt, The Revolution in Parenthood: The Emerging Global Clash Between Adult Rights and Children s Needs (New York: Institute for American Values, 2006). 8. The online survey was conducted by Abt SRBI using a sample of year olds provided by Survey Sampling International from an online survey panel. See the methodological section for details. 9. An additional 77 persons answered don t know to the question Was a sperm donor involved in your conception? That is, was your mother artificially inseminated with donor sperm from a man who was not her husband? and then responded yes to a follow up question Do you have any reason to believe a sperm donor was involved in your conception? The responses of those 77 persons are not included in the analysis for this report. (There are, however, plans to analyze the responses from those persons in a next stage of the project.) 10. All three of these groups can include persons whose parents were married, divorced, or never-married. The adopted persons were adopted 124

127 before they were two years old. The reason that the sample sizes for the three groups are somewhat different is that the donor conceived group includes 485 persons who said they knew they were donor conceived and an additional 77 persons who suspected that they were donor conceived, totaling 562 persons. After consideration we decided to analyze for this report the responses of the 485 persons who said they knew, and not merely suspected, that they were donor conceived. 11. See discussion of the methodology and limitations. 12. Elizabeth Marquardt interviewed a co-owner of the company Family Evolutions for an op-ed published in the Chicago Tribune on May 15, This quotation is drawn from unpublished material from that interview. 13. Claudia Kalb, A Sperm Biz Overhall, Newsweek, June 2, These numbers can be found in Table 1 (p. 82), which is a summary of the data (what researchers call the marginal frequencies ). 15. Quoted in Tom Sylvester, Sperm Bank Baby to Meet Test Tube Dad, National Fatherhood Initiative, Fatherhood Today, page 4, volume 7, issue 2, spring Sources for the article included Brian Bergstein, Woman to meet her father a sperm donor, Associated Press, Jan ; Yomi S. Wronge, P.A. teen to contact dad who was sperm donor, Mercury News, Jan 20, 2002; Trisha Carlson, Sperm bank baby to learn donor s name, KPIX Channel 5, Feb ; and Tamar Abrams, Test Tube Dad, viewed on April I want to know where I come from, BBC News, April 26, 2005, online edition. 17. Judith Graham, Sperm donors offspring reach out into past, Chicago Tribune, June 19, 2005, online edition 18. Sherry (Franz) Dale and Diane Allen, The Offspring Speak: Report on the 2000 International Conference of Donor Offspring (Report to Health Canada), Chad Skelton, Searching for their genes, Vancouver Sun (Canada), April 22, Knowing true identity completes puzzle, The Sun-Herald (Australia), November 3, Natasha Pearlman, I feel so betrayed because I don t know who my father is, Daily Mail (UK), February 8,

128 22. Attributed to [Mia] Lentz, 46, an advertising and marketing executive in Boca Raton, Fla., quoted in Betsy Streisand, Who s Your Daddy? US News and World Report, February 13, Christine Whipp, Worrying the wound: the hidden scars of donor conception, in Alexina McWhinnie, ed., Who Am I? Experiences of Donor Conception (Warwickshire, UK: Idreos Education Trust, 2006), Faceless fathers may be identified, The Independent, April 24, Katrina Clark, My father was an anonymous sperm donor, Washington Post, December 17, See 27. Quotations from donor offspring not otherwise cited come from interviews conducted by Elizabeth Marquardt with these persons. For some it was very important to use their real first and last name. Others preferred to use their first name only. Still others asked for a pseudonymous first name. If the first name is pseudonymous, there are quotations marks around the name the first time it is used. 28. Whipp, Whipp, Lynne W. Spencer, Sperm Donor Offspring: Identity and Other Experiences (BookSurge Publishing, 2007). 31. Spencer, Adult offspring quoted in Spencer, Tomoko Otake, The Japan Times Online, Lives in Limbo, August 28, accessed June 21, The advice columnist, Abigail Garner, who is supportive of samesex parenting, edited the letter from three separate correspondences with the same young woman. 35. Significant, p < Significant, p < All groups significantly different from one another, p < Amy Harmon, Hello, I m Your Sister. Our Father is Donor 150, New York Times, November 20, Family Scholars Blog, 40. Chad Skelton, Searching for their genes, Vancouver Sun (Canada), April 22,

129 Since most sperm used in Canada comes from the U.S., Canadians can also take advantage of American registries like Kramer s. cfm, viewed August 8, viewed August 8, viewed August 8, I could have more than 300 half siblings, The Guardian (UK), November 14, See transcript of the program titled Misconception, by reporter Tara Brown, February 22, 2004, Sixty Minutes (Australia). 47. The Offspring Speak, Posted on Family Scholars Blog, April 28, Ibid. 50. All groups significantly different from one another, p < All groups significantly different from one another, p < All groups significantly different from one another, p < Parted at birth twins married, BBC News, January 11, 2008; Unknowing twins married, lawmaker says, CNN.com/Europe, January 11, 2008; Twins separated at birth marry without knowing, The Sun, January 12, Indeed, sharing half your genetic make-up with someone could make that person seem especially familiar and sexually attractive if you did not know you were related to them. This phenomenon, known as genetic sexual attraction, is discussed in adoption literature and by donor conceived adults on their message boards. 55. Donor offspring different from both raised by biological and adopted, p <.001; adopted and raised by biological not significantly different, p = Donor offspring different from both raised by biological and adopted, p <.001; adopted and raised by biological not significantly different, p = Note that adding a family transition variable as a control to the analyses makes little difference. For instance, the greater problems experienced by the sperm donor conceived respondents is not explained by their experiencing more transitions. 58. In the survey, those from adopted families reported the greatest level of 127

130 family of origin affluence. With greater affluence it s possible that their symptoms were more likely to get diagnosed and treated. Recent reports underscore that the parents of adopted children are particularly likely to seek out health care for their children. See for example Adoption USA: A Chartbook Based on the 2007 National Survey of Adoptive Parents, a collaborative effort of several agencies within the U.S. Department of Health and Human Service. But there could be myriad other explanations behind this finding as well. 59. Donor offspring and adopted significantly different from raised by biological, p <.001; adopted and donor offspring not significantly different, p = Donor offspring significantly different from adopted and raised by biological, p <.001; adopted and raised by biological not significantly different, p= Figure 3c (p. 117) illustrates the number of family transitions among the offspring of heterosexual married parents in all three groups (the donor conceived, the adopted, and those raised by biological parents). Figure 3c includes divorce (like Figure 4) but includes other family transitions as well. 62. The number of family transitions were determined by the question Did your family situation change between your birth/adoption and age 16? If they responded yes, we then inquired about the number of changes (such as divorce, break up of a cohabiting relationship, remarriage, formation of a new cohabiting relationship, remarriage splitting up, death, or other) in the relationship status of each of the one or two parents (i.e., single mother, heterosexual married couple, lesbian couple, or other) which earlier in the survey they had stated made up their family structure at birth/adoption. 63. Significantly different, p < See for example a review by Charlotte Patterson, Children of Lesbian and Gay Parents, Current Directions in Psychological Science, vol. 15. no. 5., In Patterson s most recent study, drawn from Add Health data, there were only forty-four such teens whose parents were in such a relationship and who revealed it to the investigators. Based on that sample, Patterson and her colleagues concluded that the qualities of family relationships 128

131 rather than the gender of parents partners were consistently related to adolescent outcomes. (p. 242) 65. The numbers in the list are ranges based on Table 2 (p. 109). They do not match precisely the numbers reported in Table 1 (p. 82) because this list is based on 414 offspring who reported the structure of their family of origin, not the full 485 donor offspring who knew they were donor offspring whose responses are found in Table The difference between the donor offspring of single mothers and the donor offspring of heterosexual couples is statistically significant. 67. The lower number for the offspring of lesbian mothers is statistically significant. 68. The numbers for the section below can all be found in Table 2 (p. 109). 69. Given the cell size of the offspring born to lesbian couples, we cannot say whether this difference is statistically significant. 70. As Table 3 (p. 111) shows, all but the offspring of lesbian couples can be said to be statistically significant from those raised by biological parents. The cell size of those raised by lesbian couples is too small to know whether the differences are significant. 71. Both the donor offspring born to heterosexual parents and those born to single mothers are significantly different from the adopted. The lesbian mother sample is too small to know. 72. As Table 3 (p. 111) shows, all of the differences reported in this paragraph are significant, except for those related to the offspring of lesbian mothers. Due to their cell size we can only speculate about their apparent differences. 73. Lauren Taylor, from The following DI Offspring s quotes were distributed to the delegates at the conference, What About Me?, held at the Royal Society, London, on March 28, 2000, and organized by Comment on Reproductive Ethics (CORE), included in The Offspring Speak, Lynne Spencer, from The following DI Offspring s quotes were distributed to the delegates at the conference, What About Me?, held at the Royal Society, London, on March 28, 2000, and organized by Comment on Reproductive Ethics, included in The Offspring Speak, David Gollancz, The Offspring Speak, Janice Stevens Botsford, The Offspring Speak,

132 77. Barry Stevens on not knowing until after his father s death that he had been conceived by donor insemination, The Offspring Speak, Suzanne Ariel, The Offspring Speak, All groups significantly different from one another, p < Donor offspring significantly different from raised by biological and adopted, p <.001; adopted significantly different from raised by biological, p <.05. Within the donor conceived, 10 percent (4 out of 39) of the offspring of lesbian couples said don t know/not available to this item, compared to 12 percent of those conceived to single mothers and 5 percent of those conceived to heterosexual married couples. 81. Stephen Feldschuh, interviewed on episode Moral Issues of Sperm Donation for PBS s Religion and Ethics Newsweekly, WNET-TV, 8/25/06, cited in Naomi R. Cahn, Test Tube Families: Why the Fertility Market Needs Legal Regulation (New York: New York University Press, 2009), Joanna Scheib, Adolescents with open-identity sperm donors: reports from year olds, Human Reproduction 20 (2004) ; Joanna E. Scheib, Maura Riordan, and Phillip R. Shaver, Choosing between Anonymous and Identity-Release Sperm Donors: Recipient and Donor Characteristics, Reproductive Technologies 10 (2000): 50; cited in Cahn, 120; The Sperm Bank of California, Identity-Release Program, www. thespermbankofca.org/idrelease.html, cited in Cahn, Ova and Sperm Donation to be Legalised Croatia. A child conceived in vitro will have the right to know who their biological parents are at 18, (http://www.javno.com/en-croatia/ova-and-spermdonation-to-be-legalised --- croatia_261279) David Velleman, professor of philosophy at New York University, writes that The Implementation Handbook for the Convention makes clear that the word parents in this statement refers in the first instance to biological parents. See his Persons in Prospect, Philosophy and Public Affairs, vol 36, issue 3, , summer For example, In 2006 it was reported that just one active sperm donor remained north of the Border, forcing patients to go elsewhere for treatment or join long queues. The situation has since improved, but both 130

133 NHS and private clinics are still reporting shortages, from Lyndsay Moss, Warning over critical lack of sperm donors, The Scotsman, November 12, See Laura Witjens, Chair of the National Gamete Donor Trust, comments on egg/sperm donor payment, and see the HFEA s data at and www. hfea.gov.uk/3412.html. 89. See for example Y. Wang and A. Leader, Non-Anonymous (ID-Release) Donor Sperm is Not the Preferred Choice of Women Who Are Undergoing Assisted Reproduction, Fertility & Sterility 84, supp. 1 (2005): S204, S205, cited in Cahn, 122. Others studies and papers include Kristen MacDougall, Gay Becker, Joanna E. Scheib, and Robert D. Nachtigall, Strategies for Disclosure: How Parents Approach Telling Their Children That They Were Conceived With Donor Gametes, Fertility & Sterility 87 (2007): 524; Patricia Hershberger, Susan C. Klock, and Randall B. Barnes, Disclosure Decisions Among Pregnant Women Who Received Donor Oocytes: A Phenomenological Study, Fertility & Sterility 87 (2007): 288, 289; and E. Lycett, K. Daniels, R. Curson, S. Golombok, School-Aged Children of Donor Insemination: A Study of Parents Disclosure Patterns, Human Reproduction 20 (2005): 810; ASRM Ethics Committee, Informing Donor Offspring of Their Conception by Gamete Donation, Fertility & Sterility 81 (2004): 527, cited in Cahn More recently, see Early Disclosure of donor paternity may evince lesser negative responses in offspring, 90. At the Donor Conception Network in the UK one can find booklets and a film produced by the How to Tell Project. The booklets are available for parents of children at four different age levels. They cover issues including anxieties about telling; the best age to start telling; language to use for babies, little kids, bigger kids, teenagers, and adults; telling if a known donor has been used, and telling following the ending of anonymity for donors. In Canada, the Infertility Network has a resource page of storybooks for children about donor conception. Titles include Just the Baby for Me, for single mothers by choice to use in telling their children; How I Began: The Story of Donor Insemination, a book for 5-8 year olds produced by an Australian social workers organization; and Sometimes It 131

134 Takes 3 To Make a Baby: Explaining Egg Donation to Young Children. In the U.S., the Donor Sibling Registry has a FAQ s page which includes answers to questions such as, When is the Best Time to Tell My Child that She is Donor-Conceived? (The short answer: It s never too early. ) 91. We are continuing to analyze this data and will report additional findings in the future. 92. Donor offspring different from biological and adopted, p <.001; adopted not different from biological, p = On these four statements, the three groups of donor conceived offspring of lesbian couples, single mothers, and heterosexual married couples had similar responses, as seen in Table 2 (p. 109). 94. Donor offspring different from biological and adopted, p <.001; adopted not different from biological, p = Donor offspring different from biological and adopted, p <.001; adopted not different from biological, p = Donor offspring different from biological and adopted, p <.001; adopted different from biological, p < Donor offspring different from biological and adopted, p <.001; adopted different from biological, p < Donor offspring different from biological and adopted, p <.001; adopted not different from biological, p = As Table 2 (p. 109) shows, all three groups of donor conceived felt similar in this regard; Donor offspring different from biological and adopted, p <.001; adopted not different from biological, p = Donor offspring different from biological, p <.05; donor offspring different from adopted, p <.001; adopted different from biological, p < As seen in Table 2 (p. 109), offspring of lesbian couples appear the least likely to agree, It is wrong to deliberately conceive a motherless child, while offspring of heterosexual married couples are the most likely to agree. Interestingly, offspring of lesbian couples appear more likely to agree, It is wrong to deliberately conceive a fatherless child than they are to agree with the statement about deliberately conceiving a motherless child. A little more than one-third agree of the offspring of lesbian couples it is wrong deliberately to conceive a fatherless child, while one-quarter agree it is wrong deliberately to conceive a motherless child. The former, of course, is their own experience. 132

135 102. Donor offspring not different than biological, p =.869; donor different from adopted, p <.05; adopted different from biological, p < Donor offspring different from biological and adopted, p <.001; adopted different from biological, p < Ancillary analyses suggest that those donor offspring who have experienced negative outcomes or report experiences of hurting, confusion, etc, are about as likely as those who do not report distressing experiences or outcomes to say they favor the practice of donor conception. Analyses and reporting of this data will continue More of her story can be found here archive/7576/p23-27_walker.pdf 106. We are continuing to analyze the data and will publish findings in the future Donor offspring different from biological, p <.01; donor different from adopted, p <.001; adopted different from biological, p < There were 156 persons raised by biological parents who were raised Catholic, 33 percent of them no longer identify as Catholic. There were 122 adopted persons who were raised Catholic, 46 percent of them no longer identify as Catholic. There were 174 sperm donor conceived persons who were raised Catholic, 22 percent of them no longer identify as Catholic. The percentages for the adopted and for sperm donor conceived are both significantly different from those raised by their biological parents at p <.05 (two-tailed tests). The percentage of sperm donor conceived is significantly different from adopted at p <.001 (two-tailed tests) Donor offspring different from biological and adopted, p <.001; adopted not different from biological, p = percent of the donor offspring said they were white Hispanic, while 20 percent said they were black Hispanic Donor offspring different from biological and adopted, p <.001; adopted not different from biological, p =.559. In probing this finding, we confirmed that our survey research firm sampled nationally and not, say, with overrepresentation in the Southwest. Also note that the Hispanic respondents among those raised by adoptive and biological parents were quite low, which helps to confirm this finding is likely not due to a sampling problem. 133

136 We don t know how the donor offspring and adopted groups answer questions like these in regard to the one or two biological parents they might not know. Some might have at least basic information on their absent biological parent s race and ethnicity, while some of the donor offspring might be reporting only their heritage through their mother s side. Still others might know something about the identities of their absent biological parents or they might have a relationship with them. See, for example, AlternativeFamilies.org, which has information on helping lesbians and gay men have children through adoption, foster care, insemination, and surrogacy; an article by Michele St. Martin who argues in Donor Decisions: Considering Donor Egg & Sperm that for infertile couples and single or lesbian women who want to have a child, donor egg and donor sperm programs offer an alternative to options such as surrogacy and adoption (http://www.preconception.com/articles/alternative-family-building/ donor-decisions-1312/); and Philadelphia Family Pride s website, which says their diverse membership includes families created through adoption, surrogacy, donor insemination, fostering and heterosexual relationships, (http://www.phillyfamilypride.org/). See for example David M. Brodzinsky, Marshall D. Schechter, and Robin Marantz Henig, Being Adopted: The Lifelong Search for Self (New York: Anchor Books/Doubleday, 1992). Histories and analyses of adoption in the U.S. and elsewhere include E. Wayne Carp, Family Matters: Secrecy and Disclosure in the History of Adoption (Cambridge: Harvard University Press, 1998); Katarina Wegar, Adoption, Identity and Kinship: The Debate Over Sealed Birth Records (New Haven: Yale University Press, 1997); Adam Pertman, Adoption Nation: How the Adoption Revolution is Transforming America (New York: Basic Books, 2000); Rita J. Simon and Howard Altstein, Adoption Across Borders: Serving the Children in Transracial and Intercountry Adoptions (New York: Roman and Littlefield Publishers, 2000); and Barbara Melosh, Strangers and Kin: The American Way of Adoption (Cambridge: Harvard University Press, 2002). To learn more about the varied contemporary experiences of adoptees, the website of the Evan B. Donaldson Adoption Institute is a good place to start. See 134

137 116. Marquardt would like to thank her colleague Barbara Dafoe Whitehead for this valuable observation Among the donor conceived, offspring of married heterosexual parents are the most likely to agree with this statement. See Table 2 (p. 109) Donor offspring not different from biological, p =.485; donor offspring different from adopted, p <.01; adopted different from biological, p < It is also possible that parents raising adopted children benefit from having an equal relationship to the child neither parent is biologically related to the child while in families that have used donor insemination there is biological asymmetry; that is, the mother is biologically related to the child while the second parent is not See her many writings including a compilation of her lectures delivered in 2006 under the auspices of Canada s prestigious Massey Lectures, found in Margaret Somerville, The Ethical Imagination: Journeys of the Human Spirit (Toronto: House of Anansi Press, 2006) Advocates often conflate the idea of intentional parenthood with the presumed good of having wanted children or avoiding unplanned pregnancy. But the existing data on outcomes for children of unwanted or unplanned pregnancies is unclear. The National Campaign to Prevent Teen and Unplanned Pregnancy cites studies that find poorer outcomes related to cognition and emotional development in young children, among other factors. They also correlate unplanned pregnancy with future relationship instability of the mother, and they note that, as one might strongly suspect, most abortions are the result of unplanned pregnancy. At the same time, the majority of unplanned pregnancies are found among unmarried women, so outcomes for children of unplanned pregnancies could be confounded by well-documented outcomes for children born outside of marriage. See org/resources/pdf/fast-facts-unplanned-key-data.pdf and thenationalcampaign.org/resources/pdf/briefly-unplanned-pregnancyamong-20somethings-the-full-story.pdf In the legal realm, if advocates of intentional parenthood want to make their case based on empirical data, they have a lot more work to do. 135

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